The phenomenon, widely known as surprise billing, has troubled the United States for quite some time. It has been highlighted from time to time and fingers have been pointed at the insurance companies. The air ambulance industry is the only exception where it is being blamed for the excess bills that people are compelled to foot. Why so? The answer is obvious: the size of the bills is so big that it often makes headlines. In this context, the pertinent question to ask is this: is surprise billing a problem that is limited to the air ambulance industry? The answer is a resounding ‘no’.
Air Ambulance Services and the Concept of Insurance Network
Imagine a situation where you have to get checked for a potential disease that can be life-threatening. You take care to ensure that you choose a hospital that is within your insurance network. You are referred to a specialist and a few lab tests are ordered. A week later, you come to know that the specialist and the lab tests are not within the insurance network and you are expected to pay off the bills all by yourself. It seems like a no-win situation, right?
Whose Responsibility is to Verify Insurance Network?
It is unrealistic to expect the patients, who often are in emergencies, to verify network coverage before availing treatment. The responsibility must, therefore, be jointly shared by the service providers and the insurance companies. At present, that is not the case. This is the precise reason why surprise billing is so prevalent. In the case of air ambulance services, this amount is usually pretty steep, driving families towards bankruptcy. The blame ultimately is pinned on the air ambulance industry, which is not entirely fair. However, it must be noted that the medical flight industry is loosely regulated when it comes to billing practices and must be scrutinized too.
People around the world are wary of getting out of the confines of the home due to the COVID-19 pandemic. The result has been a reduction in emergency calls for the air ambulance industry. The change has come into play due to the reduced crime rates and accidents as fewer people have ventured out lately. While this is a good sign in general, there is a negative commercial aspect to it that can affect this commercial emergency service profoundly. It must be understood that reduced calls affect the revenue of the air ambulance industry in general where most players are heavily indebted.
The Expenses have Increased
Responding to emergencies is no longer the same as it used to be. The COVID-19 pandemic has changed things deeply. Today, the paramedics must sport personal protective equipment (PPE) before they venture out into helping anyone on the ground. This is essential to protect the crew’s health and also that of the person who is facing the emergency. This results in a further uptick in the cost as these PPEs cannot be reused. Also, there are protocols in place for sanitization after each evacuation, which further adds to the cost.
The Air Ambulance Industry is Seeking Financial Aid
It is not that there has been no financial aid coming towards the air ambulance industry; however, it is yet to be seen how effective the distribution has been. It must be noted in this context that several small players in the industry cater to rural communities. These critical services are the only line of defense for these communities where local hospitals have shut down in large numbers. If these organizations are not helped financially, they might eventually shut down. It is therefore vital that a close watch is kept on the industry’s requirements.
The lockdowns around the world are easing, down and people are slowly gaining the confidence back to venture out and involve in matters that are pressing for a society to function normally. One of such activities is medical flight charity. Countries like the United Kingdom depend heavily on public contributions to keep the air ambulance services running. Here are a few developments that stand evidence to the fact that they are inching towards normalcy.
A Kid from Reading Raising Money for Medical Flight Services
Alfie, an 8-year-old boy, has made news for his efforts to raise money for Children’s Air Ambulance. This enterprising child organized a sponsored run and has been selling bird feeders to raise money. It is believed that he has already raised a few hundred pounds through his relentless efforts. Alfie is a part of #TheCrew, a children’s club, involved in raising money for the worthy cause.
Medics in Ireland take up Cycling Challenge to Raise Money
A team of 11, comprising of an engineer, six doctors, and 4 paramedics is all set to take up a cycling challenge that will cover 110 miles. The effort has come in the face of COVID-19 pandemic, which stalled several fund-raising efforts. The endurance challenge is set to take place between the 2nd and 3rd of October. The expectation is that it will raise the much-needed funds to keep the medical flight services going. They are doing this for the Northern Ireland Air Ambulance.
Midlands Air Ambulance Charity goes Virtual
This charity has revealed that their pre-hospital services have shot up by 35% due to the COVID-19 pandemic. The organization has, therefore, decided to give the community that it serves an insight into what typically goes on. It will, of course, be a fund-raising initiative too. The organization has taken the virtual route to ensure the safety of the community amid the pandemic.
Congress has been focussing heavily on eliminating surprise billing practices and involves not just the air ambulance industry but the healthcare landscape as a whole in the United States. In this regard, one significant development has been the introduction of the Consumer Protection Against Surprise Medical Billing Act. The Act is currently slated to enter the United States House of Representatives for a vote. Thus far, the billing practices of the industry have found protection under the Airline Deregulation Act of 1978, which precludes the states from interfering in the matters of medical flight billing.
The New Bill and Air Ambulance Billing
The most important provision of the bill is that it will protect all the patients against balance billing practices even if the service provider is out-of-network of the insurance company. The patients will only be charged according to the in-network charges, which obviously will be covered by their insurance.
Explanation of benefits in advance is another important provision. Currently, the patients have no say in opting for air ambulance services during emergencies. The healthcare provider would take the call during the emergency, and the patient would not have a say. This will change with the introduction of the new bill, allowing the patient to make an informed decision.
If the new bill is successful, the air ambulance service providers would be compelled to give cost estimates before providing the services to the patient. In essence, the patient will be able to make a prudent financial decision if he or she is paying by cash or is uninsured.
A mediated process for resolution of the dispute would be put in place. Any party involved including the air ambulance company would be free to dispute any part of the payment through a mediated process. There would be a window of 30 days to find a resolution.