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Air Ambulance Bills (California)

PostPosted: Sun Aug 28, 2011 2:30 pm
by 50Cal20
Last year air ambulance bills were removed from the industrial fee schedule. For those claims adjusters who pay air ambulance bills I would like to ask what is your company's procedure regarding payment of such bills now that they are not part of the fee schedule? When a procedure is no longer included in the fee schedule it doesn't mean that the provider gets paid whatever they ask for. Yet, I am seeing some companies paying these bills in full, without queston, at a cost between $18,000 to $38,000 per trip. They do so because they don't now how to challenge the bill. For those companies who cut air ambulance bills, what authority is being used to do so and how are calculations done? I am gathering answers to this question to be part of an educational seminar program next year to the insurance and self-insurance industry.

Re: Air Ambulance Bills (California)

PostPosted: Mon Aug 29, 2011 8:56 pm
by 50Cal20
Well, I see that many people are reading the question that was posted but that nobody knew the answer. Am I to assume that everyone pays air ambulance companies every cent they ask for? I am beginning to think they do. Every company that I have spoken to is unaware how to challenge a bill, so they end up paying it in full. Isn't it amazing how companies will pay a $35,000 air ambulance bill without blinking an eye simply because they don't have the education budget to teach their adjusters how to challenge the bill? Air ambulances seem to have a gold mine right now. I just saw a bill today for over $46,000 that was paid in full without objection. If they had billed it for $100,000 I bet they would have been paid. I plan to include this topic in January in a statewide lecture that I will be giving.

Re: Air Ambulance Bills (California)

PostPosted: Tue Aug 30, 2011 7:23 am
by jpod
Or we just have never paid for an air ambulance.....

Re: Air Ambulance Bills (California)

PostPosted: Tue Aug 30, 2011 7:15 pm
by 50Cal20
The number of air ambulance bills in workers' compensation was apparently significant enough to generate a revision of the Regulations to remove these bills from the fee schedule. The alternative was to proceed with a suit that was being brought by the Air Ambulance industry. By amending the Regulations the suit was dropped. So yes, there are a lot of air ambulance bills out there.

Re: Air Ambulance Bills (California)

PostPosted: Tue Aug 30, 2011 11:56 pm
by chirple
I see air ambulance bills headed in the same direction of the ambulatory surgery center bills, absent fee schedule.

The air ambulance companies argue Federal protection from State regulation, in a line of cases, but I do not beleive that prohibits the WCAB from taking jurisdiction to determine reasonableness of charges.

Discovery will focus on usual and customary charges, contracts with private insurance carriers (which the companies will try to deny exist or claim confidentiality), and the litigation will continue.

Re: Air Ambulance Bills (California)

PostPosted: Wed Aug 31, 2011 9:26 am
by suekarp
Hey 50cal,
Can you share some of your practice tips for cutting air ambulance bills before your state-side tour? :D

Re: Air Ambulance Bills (California)

PostPosted: Thu Sep 01, 2011 9:10 pm
by 50Cal20
Yes, I will provide a sneak preview in December when the IEA advertises my January seminars. Meanwhile I still would like to know if there are any companies out there that cut air ambulance bills rather than just pay them in full without question.

Re: Air Ambulance Bills (California)

PostPosted: Sat Jan 07, 2012 12:45 pm
by 50Cal20
As promised in a past posting here is a sneak peak at Air Ambulance bills and what can be done about them. First of all not all Air Ambulance services were removed from the Official California Medical Fee Schedule. Only interstate transportation is exempt from the fee schedule. Yet, nobody knows that and air ambulance companies are deliberately misleading the workers' compensation industry into believing otherwise. My New Laws of 2012 Seminars for the IEA begin next week and this matter will be thoroughly discussed at that setting.

Re: Air Ambulance Bills (California)

PostPosted: Thu Jan 31, 2013 2:11 pm
by bethstalker
I have some info that might be able to help you. We have been gathering information on this topic two years ago.