SabrinaP
Pearl Clutcher
Busy Teacher Pea
Posts: 4,350
Location: Dallas Texas
Jun 26, 2014 12:16:22 GMT
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Post by SabrinaP on Jul 3, 2016 23:42:44 GMT
In early October, I fell down some dark deck stairs while vacation with my family and had to be taken by helicopter because the nearest hospital was 1 1/2 hours away. I shattered my tibia, so I needed surgery to repair. At the time, my family was concerned that I had hit my head and was going into shock, so the ambulance was called. The ambulance company took my to the helicopter and off we went. We got a bill for $42,000 from the helicopter company after my insurance denied it the first time, but they asked for my permission to fight the insurance company on it. I hadn't heard anything in months, so I thought all was fine. Today I got a letter to call the helicopter's self pay line because they were not able to come to an agreement with insurance.
Ug! Where do I start? Call the insurance company? I'm at my max out of pocket with this accident, so they would have to pay 100%. This bill is stressing us out!
Update: Insurance denied the bill because the helicopter is out of network. I argued that obviously there is no way to choose a helicopter. Going out of network was not a choice in this situation. I hit a wall with insurance. Called the helicopter company and they knocked the bill down to $13,000 if we pay it in the next 30 days or $281 a month for the next 5 years. DH and I contacted the Texas Department of Insurance and are first going to get them to mediate with the insurance company on our behalf. The helicopter company said we could pay $25 a month to keep the account current, so we will do that for now and keep trying to get it worked out.
So now a $42,000 bill is a $13,000 bill. Better, but combined with my max out of pocket of $7,000 that we have from the hospital and everything else associated with this accident, and DH and I are struggling.
Prayers and positive thoughts are greatly appreciated!
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seaexplore
Prolific Pea
Posts: 8,420
Apr 25, 2015 23:57:30 GMT
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Post by seaexplore on Jul 3, 2016 23:50:33 GMT
Holy crap! Hope you enjoyed that ride! Yes, call your insurance and fight with them. Do you have all the documents you've been given? Look thru your policy and get to know it. There could be something in there that you can use to fight it.
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johnnysmom
Drama Llama
Posts: 5,682
Jun 25, 2014 21:16:33 GMT
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Post by johnnysmom on Jul 3, 2016 23:52:23 GMT
Yowzers! Absolutely start with the insurance company. If that doesn't work, where did it happen at? Could you file a claim against their insurance?
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SabrinaP
Pearl Clutcher
Busy Teacher Pea
Posts: 4,350
Location: Dallas Texas
Jun 26, 2014 12:16:22 GMT
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Post by SabrinaP on Jul 3, 2016 23:54:10 GMT
Yowzers! Absolutely start with the insurance company. If that doesn't work, where did it happen at? Could you file a claim against their insurance? It happened at a rental cabin. That may be what we have to look into next.
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johnnysmom
Drama Llama
Posts: 5,682
Jun 25, 2014 21:16:33 GMT
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Post by johnnysmom on Jul 3, 2016 23:56:51 GMT
Yowzers! Absolutely start with the insurance company. If that doesn't work, where did it happen at? Could you file a claim against their insurance? It happened at a rental cabin. That may be what we have to look into next. They should (I hope!) have liability insurance with medical coverage. Do they know you fell there?
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Post by AussieMeg on Jul 4, 2016 0:00:45 GMT
OMG that's horrendous!! I hope you get it sorted through your insurance company.
I don't have private health cover but I do have ambulance cover. It only costs $87 for the year for the whole family to be covered fully, including air ambulance.
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Post by mikklynn on Jul 4, 2016 0:03:46 GMT
Yikes! I'd call your state Attorney General, while fighting with the insurance company.
I'd also be combing through the fine print in my policy.
Is the insurance through an employer? Maybe HR could help?
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Post by gorgeouskid on Jul 4, 2016 0:05:01 GMT
Time to lawyer up.
No one else will be able to help you. The system is not designed for human people.
Good luck!
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Post by hop2 on Jul 4, 2016 0:12:39 GMT
Follow up your call in writing!!! Insurance companies deny anything not 'required' to be covered first shot because approx %50 of people won't file an appeal in writing. They can ignore phone calls all day. They can tell you everything you want to hear in a phone call and not follow thru. Most policies even state that what they say on the phone is not necessarily correct ( lol ) but if you want them to pay a claim they have denied you have to file a written appeal.
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Post by Eddie-n-Harley on Jul 4, 2016 0:15:55 GMT
Yikes! I'd call your state Attorney General, while fighting with the insurance company. Why the attorney general? SabrinaP, check to see if your state has an insurance commissioner or ombudsman's office; that's a common resource for consumers.
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Deleted
Posts: 0
May 14, 2024 19:56:49 GMT
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Post by Deleted on Jul 4, 2016 0:31:41 GMT
SMH at $42K (Not at you OP, just at all of it) Time to lawyer up. No one else will be able to help you. The system is not designed for human people. Good luck! I hate it, but I don't see what else you can do.
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Post by LiLi on Jul 4, 2016 0:33:37 GMT
There are news stories all over the internet about helicopter flights and insurance. Man, who would have thunk??! It sucks how they are taking advantage of people when they need help most! I hope you get it worked out.
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Post by mikklynn on Jul 4, 2016 0:34:22 GMT
Yikes! I'd call your state Attorney General, while fighting with the insurance company. Why the attorney general? SabrinaP , check to see if your state has an insurance commissioner or ombudsman's office; that's a common resource for consumers. The AG acts as a consumer advocate. They may not investigate this issue, but they will direct you to the proper agency. I had a problem once and they directed me to the Commerce Dept., who did help me.
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Deleted
Posts: 0
May 14, 2024 19:56:49 GMT
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Post by Deleted on Jul 4, 2016 1:10:05 GMT
This is not the first time I have heard helicopter ambulance rides to cost $30-40k. Definitely appeal, definitely talk with HR if it is an employer-sponsored health plan. I do hope you notified the owners/rental agency at the time that it occurred so that they notified their insurance company at the time. There might be a statute of limitations on that notification/claim, so I would do it as soon as possible.
I am kind of surprised the health insurance company didn't try to already get that information and subrogate it to their property insurance coverage honestly.
You might need to get the ambulance company (the one that took you to the helicopter) to write up a document on why you needed to be airlifted.
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quiltz
Drama Llama
Posts: 6,707
Location: CANADA
Jun 29, 2014 16:13:28 GMT
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Post by quiltz on Jul 4, 2016 1:36:56 GMT
There are news stories all over the internet about helicopter flights and insurance. Man, who would have thunk??! It sucks how they are taking advantage of people when they need help most! I hope you get it worked out. Where was the OP taken advantage of by the helicopter flight? This was the only way that she could be transported to the hospital. Insurance companies always try not to pay, however, sometimes ambulance helicopter rides are not included. It is important for everyone to know the details of their coverage. The vacation rental home should have been notified as soon as possible after the accident. Then the OP's Insurance would deal with the Vac home rental insurance. Hopefully there is still time.
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Post by LiLi on Jul 4, 2016 1:42:09 GMT
There are news stories all over the internet about helicopter flights and insurance. Man, who would have thunk??! It sucks how they are taking advantage of people when they need help most! I hope you get it worked out. Where was the OP taken advantage of by the helicopter flight? This was the only way that she could be transported to the hospital. Insurance companies always try not to pay, however, sometimes ambulance helicopter rides are not included. It is important for everyone to know the details of their coverage. The vacation rental home should have been notified as soon as possible after the accident. Then the OP's Insurance would deal with the Vac home rental insurance. Hopefully there is still time. I was referring to the articles I read on line, specifically about emergency helicopter companies ripping people off. It's practically a racket. Go see for yourself, if you care to.
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Post by anniefb on Jul 4, 2016 1:44:33 GMT
That's terrible SabrinaP. Hope you can get it sorted. I'm very grateful that here in Auckland we have a rescue helicopter service that's partly government funded and also supported by private business - so there's no charge for patients who are evacuated in cases of medical emergency.
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quiltz
Drama Llama
Posts: 6,707
Location: CANADA
Jun 29, 2014 16:13:28 GMT
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Post by quiltz on Jul 4, 2016 1:46:56 GMT
Where was the OP taken advantage of by the helicopter flight? This was the only way that she could be transported to the hospital. Insurance companies always try not to pay, however, sometimes ambulance helicopter rides are not included. It is important for everyone to know the details of their coverage. The vacation rental home should have been notified as soon as possible after the accident. Then the OP's Insurance would deal with the Vac home rental insurance. Hopefully there is still time. I was referring to the articles I read on line. It's practically a racket. Go see for yourself, if you care to. I don't need to read articles on line. I am unfamiliar with USA health & there are enough differences between the provincial health coverages. Thanks for the info.
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Post by jamielynn on Jul 4, 2016 2:11:48 GMT
We have experience with this. I sent a pm with details.
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Post by kellybelly77 on Jul 4, 2016 2:20:34 GMT
What was the exact denial the first time? Out of network? Not medically necessary?
Also, since last Oct. you may be out of time to appeal. If in fact the air company was doing it on your behalf it may have extended the timeline a little but 9 mo later is pushing it.
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Post by kellybelly77 on Jul 4, 2016 2:22:49 GMT
Why the attorney general? SabrinaP , check to see if your state has an insurance commissioner or ombudsman's office; that's a common resource for consumers. The AG acts as a consumer advocate. They may not investigate this issue, but they will direct you to the proper agency. I had a problem once and they directed me to the Commerce Dept., who did help me. It's not the AG's office. Every state has an Insurance Commissioner that has authority to regulate insurance companies. They all have a consumer complaint dept. I would start the process with them as well. If this is a self funded employer plan though there isn't a whole lot they can do.
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PLurker
Prolific Pea
Posts: 9,744
Location: Behind the Cheddar Curtain
Jun 28, 2014 3:48:49 GMT
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Post by PLurker on Jul 4, 2016 2:39:13 GMT
I recently saw a news program where it said helicopter companies over-bill people who could pay to cover those they know won't/can't so you are actually paying for more than just you. I wasn't paying attention well but it sounded crazy but I don't know if there was a solution or route to take.
I would definately do a lot of investigation and follow through. Doesn't seem right.
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Post by hosschick on Jul 4, 2016 3:00:23 GMT
No advice but I feel ya! DH was life flighted for a heart attack in November and our insurance has yet to pay. We just keep going back & forth. It's definitely frustrating.
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tincin
Drama Llama
Posts: 5,368
Jul 25, 2014 4:55:32 GMT
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Post by tincin on Jul 4, 2016 3:37:54 GMT
In early October, I fell down some dark deck stairs while vacation with my family and had to be taken by helicopter because the nearest hospital was 1 1/2 hours away. I shattered my tibia, so I needed surgery to repair. At the time, my family was concerned that I had hit my head and was going into shock, so the ambulance was called. The ambulance company took my to the helicopter and off we went. We got a bill for $42,000 from the helicopter company after my insurance denied it the first time, but they asked for my permission to fight the insurance company on it. I hadn't heard anything in months, so I thought all was fine. Today I got a letter to call the helicopter's self pay line because they were not able to come to an agreement with insurance. Ug! Where do I start? Call the insurance company? I'm at my max out of pocket with this accident, so they would have to pay 100%. This bill is stressing us out! Whose deck steps did you fall down? I would start with their insurance company. Save
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mlana
Pearl Clutcher
Posts: 2,523
Jun 27, 2014 19:58:15 GMT
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Post by mlana on Jul 4, 2016 4:08:25 GMT
I'd start by calling the financial office of the insurance company. They may be able to tell you why it was denied. Sometimes it's just a coding error or a problem where all the paperwork wasn't turned in together. If the insurance company and the air ambulance company have an agreement in place and the air ambulance company didn't follow procedure either at the time of your injury or in the paperwork, you may not be liable for any part of the bill.
When DH had his stroke, he had to be transported to 2 different hospitals in one day. The same ambulance company handled both transports and they billed separately for each transport. When I got a bill from the company, I called my insurance company and asked what I should do with it. They were really surprised that the transport company had billed me because they had an agreement with my insurance and should have billed them directly. I called the ambulance company and gave them DH's insurance info again, as well as the fax number where the insurance company said they should send the bill.
Over the next 5 months, I got several more copies of the bill from the transport company and each time I reached out to them with the info from the insurance company. On one occasion, I stayed on the line with my insurance company while they called the transport company and asked them to send the documents to them. After 6 months, the transport company failed to bill the insurance company. I received a letter from my insurance company about a mo the later telling me that they had never received any bill from the transport company so, under the agreement between the two companies, I was not responsible for any portion of the bill, not even a copay or coinsurance amount.
You may want to file a claim against the rental cabin's insurance right away. There is a limited time for you to file a claim after an injury. I've received calls and letters from my insurance company any time one of us was injured in a way that could possibly be covered by our homeowners' insurance. Each time I had to detail how and where whoever had been injured. I hate to admit what klutzes we are!
Marcy
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Deleted
Posts: 0
May 14, 2024 19:56:50 GMT
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Post by Deleted on Jul 4, 2016 13:05:11 GMT
I'm so sorry you're going through this. It sounds super stressful and I had no idea an emergency medical situation could result in such a big headache for people. It seems like the Peas have some great advice for you. I hope you get a resolution very soon.
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gsquaredmom
Pearl Clutcher
Posts: 4,078
Jun 26, 2014 17:43:22 GMT
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Post by gsquaredmom on Jul 4, 2016 13:19:14 GMT
I am pretty sure my hmo does not cover helicopter transport. If I got such a bill and could not work it out, and they would not take a monthly payment forever, I would need to look into medical bankruptcy.
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georgiapea
Drama Llama
Posts: 6,846
Jun 27, 2014 18:02:10 GMT
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Post by georgiapea on Jul 4, 2016 13:23:11 GMT
Wow, now I know why DH's insurance includes being air lifted! I would file a claim against the place where you were staying.
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les935
New Member
Posts: 6
May 16, 2016 21:42:21 GMT
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Post by les935 on Jul 4, 2016 13:38:47 GMT
Yes, you really need to lawyer up. We had a $49,000 bill from a helicopter flight when my two year old son suffered a horrible burn on a camping trip. You will not get anywhere without a lawyer. In our case, insurance only want to pay $3500 of that bill even though we had met our deductible for the year, and after fighting the denial, the insurance company won. We took it to our state's insurance regulator and was told while the insurance company's refusal to pay was not ethical, it was not illegal. Our lawyer was able to get the helicopter company to settle for $8000 from us in addition to what insurance did pay. Without him pushing for us, we would have been responsible for every penny.
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Post by librarylady on Jul 4, 2016 14:31:14 GMT
FWIW-- We learned that Care Flight offers a $50/year membership. If one pays that $50 within 24 hours of the flight, then that is all it costs. The person who told us this said that other air ambulance companies do not offer that. Other air ambulance companies require membership prior to any flight.
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