Investigative

Sky High Bill: Patient that got $50K-plus charge for medevac given no other options

YORK COUNTY, Va. (WAVY) -- Most of us have received big bills for medical care, and wondered whether insurance would cover it, but a York County couple got a real shocker that made them call 10 On Your Side.  

"I came home and found my wife, Mary Beth, she was slumped over," said Ralph Hanes.

That was on Thursday, August 9, 2018. Ralph called 911.

"They got her some oxygen, and started taking blood tests. The medics take Mary Beth to Riverside Doctor's Hospital in Williamsburg. 

Ralph says she had a blood clot on her lung. Then, the next day on Friday morning, "I'm overhearing conversations that they are arranging transport for her. It was 6 a.m. and I realized they were calling a medevac helicopter."

There was no discussion, no consultation, no ambulance as an alternative. There was a helicopter to VCU Medical Center in Richmond, and that was it.

No options were given to the Hanes. 

"I don't ever remember anyone telling me how much this is going to cost," Ralph said.

He'd find out soon enough. 

VCU contracts with Air Methods, based at the Middle Peninsula Airport near West Point. University officials sent a statement to 10 On Your Side regarding its arrangement with Air Methods.

VCU Health System contracts with Air Methods to provide air medical transport services. Under this arrangement, Air Methods bills and collects payments from insurance companies and patients for any air medical transport services; VCU Health System does not. Any payments made for air medical transport services go directly and solely to Air Methods. 
 
Air ambulance transport services like Air Methods transport patients to the nearest appropriate facility based on location and availability. As a comprehensive Level I adult, pediatric and burn trauma center, VCU Medical Center may sometimes be the most appropriate facility.

Air Methods flew Mary Beth 45 minutes to VCU Medical.

Ralph would follow in his car. He drove west on I-64, the same route an ambulance would have taken, and got there 30 minutes after the chopper.  There's no doubt Mary Beth was in serious condition. She would sleep three days, finally wake up, and would then be at VCU for five weeks.

After the Hanes got home, it didn't take long for Air Methods to start calling, and calling, and calling.

"I'm thinking it's a pretty big bill here. They're really cutthroat. They really want their money," Ralph remembers.

How much was that 47-mile flight up Interstate 64 to Richmond?

Almost $54,000 dollars, including $400 bucks a mile. 

Now Ralph wonders, "Why can't she be transported in an ambulance? What is so urgent about a helicopter?" 

He also wondered in the beginning how he was going to pay.

"I am thinking how am I going to pay for this? A loan, a payment plan?"

Air Methods continued to call the Hanes.

"Air Methods, I never want to hear that word again," says Mary Beth, who was in recovery having to deal with Air Methods too.

"I told her (the caller for Air Methods) at this point I'm considering this harassment because we've received so many phone calls from your company," Mary Beth said. 

In the end, thanks to Ralph's employer's insurance, Air Methods' final bill shows up to the Hanes as "bill paid."

10 On Your Side was curious about the cost of an ambulance for the same trip. We went to Riverside's corporate headquarters in Newport News to do an on-camera interview, but that was canceled by spokesperson Peter Glagola. 

We wanted to know why Riverside chose to fly in a helicopter to take Ms. Hanes from Williamsburg to Richmond, which is only 47 miles up I-64 and cost $54,000. 

Glagola, who met 10 On Your Side at the door, reiterated he would do no on-camera interview. He sent us a statement that read in part, "We call air transportation only when the patient is in an emergency situation and time is of the essence."

Glagola also confirmed ground transportation is $983 and $15 a mile. 

That same trip would have been $1,700 using ground transportation, compared to the $54,000 helicopter ride. 

We asked Glagola: Why didn’t Riverside get a land ambulance?   

He responded, "In the case when a physician designates a patient, typically in the ICU, as an emergency transfer or is becoming unstable, then at that point the patient is flown to the other facility.

Why didn't the attending physician inform the Hanes of options available, land over air? 

Glagola answered: "In the case where a patient is designated an emergency and is becoming unstable  the physician will order the transport they believe is best for the care of the patient. There is not a lot of discussion. The physician does what is necessary to make sure the patient remains safe and gets the care needed so they can get back to normal life."

The Hanes think in hindsight the helicopter ride wasn't worth it, and more importantly wasn't necessary.

Mary Beth was in serious condition, but stable. She had been at Riverside all night, and looking back they don't think there was a rush, and certainly not one that would cost $54,000. 

"That is what I would ask the doctor. For an hour ride in land transportation, couldn't she be stable  enough," Ralph said. "What do you think could happen within that hour that could jeopardize her health?"

As for Air Methods, 10 On Your Side went looking for answers at their airport hanger near West Point. 

The pilot and crew referred us to corporate headquarters in Colorado.  Repeated calls to that office finally led a statement from Air Methods Director of Communications Doug Flanders, who emailed a lengthy statement. Here is the statement summarized:

"We deliver ... emergency, lifesaving care to anyone who needs it ... we are first responders ... Air Methods does not self-dispatch ... we go when called ... we don't have patients' insurance status at time of call ... around-the-clock readiness averages nearly $3 million per year for each air base maintained by emergency air medical providers."

READ: Full statement from Air Methods

"That's a pretty penny," said Virginia State Senator Jeremy McPike (D) Dale City, who happens to be a fire captain in the Dale City Volunteer Fire Department.

He introduced Senate Bill 663: "Air Medical Transportation; informed decision" law which takes effect March 1. 

Senator McPike says, "We need to say, here's the carrier, here's what they are offering you, you can go by helicopter or by ground ... in a non-emergency situation, let's slow it down. Let's make sure our patients have options. $52,000 that's a life savings that will put somebody in bankruptcy. We have to inform patients."

This bill requires each hospital to establish a protocol requiring that, before a health care provider arranges for air medical transportation services for non-emergency medical conditions, that options for the patient be communicated to the patient and or the family.  

But the Hanes had an emergency situation and they think they should have been given the options too. 

"If it would have been approached to me, I would have asked what are the pros and cons?," Ralph said. "What could happen and what could not happen?" 

Obviously if it is an emergency of life and death and there is no time to talk about options other than the option to immediately get the patient to a trauma center right now, then you have to take the helicopter. 

The Hanes argue although Mary Beth was in a serious condition, she was not near death, even after being asleep for three days and then being in a hospital five weeks. She had also been at the Riverside facility overnight before the helicopter was called. 

Senator McPike adds, "That's the point. Let's have some transparency about the pricing before literally you get on the ride, and you're taken for a ride when it comes to the pricing, and that's not right."


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