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Tips for Case Managers to Plan Air Ambulance Transport

A case manager’s job can be hectic, especially when it comes to coordinating air ambulance transport. Even the most experienced ones may only coordinate a few of these every year. So it may be difficult to be informed on all the details necessary in planning a successful transport. Maybe you got all the details of their medical needs correctly but forgot to verify the patient’s insurance coverage. Or maybe you missed out on verifying the certifications of the air ambulance company. There are plenty of details one should remember when coordinating transport via an air ambulance and here’s a tip to help you out.

Assess the Various Needs

Before a patient avails air ambulance transport, you need to contact the discharging physician for medical reports and also ascertain the reason for transport. You will need to establish the date of transport and coordinate with the accepting facility. The process of assessing needs also involves recapping the patient’s current condition and determining their life support needs. Before you move on to the next step, you need to identify the payer – whether it’s the insurance company, patient or patient advocate, or facility.

Collect estimates for Air Ambulance Transport

The next step requires you to secure air ambulance estimates, which involves determining an estimated cost of the transport and details of the service. This means determining the aircraft type, whether or not the service is bed-to-bed, etc. You will need to verify a few things including insurance coverage, personnel qualification, and whether or not the entity is an operator. Another certification you need is for the entity in terms of industry associations and FAA Part 13 certificate. Don’t forget to provide transport parameters and verify everything in writing.

Before executing transport, make sure you secure an itinerary from the operator and coordinate with the floor. Verify details like pickup time, transport/discharge orders, and receiving facility. Keep the receiving facility updated on the patient’s condition for a smooth transport.

Are Air Ambulances Really Necessary?

The question has been long debated in the medical circles and the civilian population, especially considering the growing costs of hiring air ambulances. Here, we discuss a few arguments against the efficacy of air ambulances and point out why these arguments hold no water.

Publication on Air Ambulances by University of Texas Medical Branch

This research dates back over a decade. So, discounting the fact that the traffic as well as the overall population has increased today, we still go by the argument presented in the publication. The study was conducted taking into consideration data that followed 24 months after a hospital discontinued air ambulances and comparing it with the data 12 months preceding the discontinuation of air ambulances.

The study concluded that the discontinuation of the air ambulances did not increase death rate of patients with trauma or increase the transport time. Now, a lot of people arguing against the necessity of air ambulances might cite this finding. However, looking at the “abstract” of the publication, it is apparent that a few vital factors have not been considered.

Without the Air Ambulances, did the Same Number of Patients Reach the Hospital?

That’s the important question. The study says admissions to trauma unit decreased 12%. There was a whopping 17% decrease in admissions involving severe injuries. With the number of road accidents on the rise in the United States continuously, it seems surprising to see the number of emergency cases being reported to a hospital decreasing.

One explanation could be that those cases which demanded urgent attention did not actually receive it due to unavailability of air ambulances. That certainly is not an encouraging sign. The air ambulance networks that are available today can not only reach the patients on time and take them to the nearest appropriate facility, but also offer life-saving treatments during the flight. In fact, we have highlighted the need to get the patients adequate treatments before the golden hour earlier in one of our reports.

People who argue against the need of air ambulances must take the whole picture into consideration before making such sweeping statements.

Pill over a dollar bill

Guide: Air Medical Transport Cost Determination

With the cost of even a short air medical transport flight running into thousands of dollars, a little homework before zeroing on one is not a bad idea, especially if you have the liberty of doing so. Keep in mind that you would not have the liberty or time to choose an air medical transport operator during emergencies. However, if the situation is not life-threatening, it pays to look into certain aspects.

How Far is the Air Medical Transport Vehicle from You?

You might be paying for the distance covered by the air medical transport vehicle to reach you. So, it’s vital that you contact a local air ambulance company, which stations its vehicle close to you. This can save you several hundreds or even thousands.

Have you Got a Final Quote for the Air Ambulance Transport?

The quote that you receive from the company might not be all inclusive. This means you might have to shell out more money than what is mentioned in the quote. Contact your flight coordinator to know the exact details about the price quote.

Does your Insurance Cover Air Ambulance Transport?

There are several guidelines that one needs to follow to assure smooth coverage of air ambulance transport costs by the insurance provider. Look at aspects such as medical necessity, closest appropriate medical facility, and treating physician’s approval even before you start looking for an air ambulance.

Does the Air Ambulance Company offer Comprehensive Services?

There are several aspects that must be taken care of:

  • The transport of the patient from the hospital to the air ambulance
  • Transport from air ambulance to ground ambulance
  • Coordination with receiving facility
  • Medical repatriation beyond borders

Opt for an air ambulance company that covers these corners. Involving yourself in these matters can be time consuming and might cost you extra.

Finally, check whether you can substitute air ambulance for a commercial airline. Simple things like IV fluids, professional care, and stretchers can be accommodated in a commercial airline too, which cost far less than an air ambulance.

Medical Flight Services – to Call or Not to Call; that’s the Question

The call for medical flight services is usually left to the professionals who evaluate the situation and make a decision. However, the payment for the medical flight services almost always falls on your shoulders, and this can often turn out to be a huge burden.

What if the $10,000 call for medical flight services was totally unwarranted and you would have only incurred a few hundred dollars if you had opted for ground ambulance services? Here, we discuss a few factors that decide whether medical flight services should be pressed into service or not.

Is the Injury Life-Threatening to Warrant Medical Flight Services?

The concern for your loved ones is understandable but unless the patient is in a life-threatening situation and medical flight services can reduce the risk, there is no point calling for one. One must keep in mind that concern and fear are not the reasons to call medical flight services.

Discuss the extent of the injury with the qualified personnel who takes the call and voice your opinion. At the end of it, it is you who will have to make the payment and insurances won’t pay unless the reason for calling medical flight services is valid.

Will Medical Flight Services Actually Save Time?

Air ambulance cannot land just about anywhere. They need adequate landing facilities and if such a facility is too far, it is futile to transport the patient there. You are better off transporting the facility to the appropriate nearest medical center through land transport. Also, there must be a reasonable time difference between the land and air ambulance transport to the destination.

Are the Weather Conditions Congenial for Medical Flight Services?

FAA is already trying its very best to raise the safety standards of medical flight services. Bad weather and poor visibility are risky by themselves. A land ambulance would be a much safer choice in circumstances like these.

There are a lot of technicalities involved with air ambulance services and it is not always the quickest option. So, discuss the mode of transport with the decision-making authority on the scene, although you don’t have the real authority for making the decision when you are dependent on insurance for cost coverage.

Look Beyond Prices of Medical Flights

Speak of flights and the first thing that comes to mind is the price tag; however, one needs to look at medical flights from a totally different perspective. While price can be a criterion, it can never be the only one. Here are certain factors that you must be taking into consideration to ensure the wellness of your loved ones while choosing medical flights.

The type of medical flights being used

Not all medical flights have the capability of running in tough weather conditions. Plus, the air ambulance needs to be cabin pressurized for patient safety. There are aircrafts that are often used part-time as chartered planes; you are advised to steer away from such medical flights as the chances of them being fully equipped medical emergencies is questionable.

Medical flights and safety compliance

Look for the accreditations. A company that complies with the rules laid down by the Federal Aviation Administration is the best one to choose. Violation of these norms is usually recorded and made public so that people have the choice to avoid them.

Medical flights with qualified crew

This one might come as a shock to you but providers of medical flights are not mandated by the government to maintain standards when it comes to qualified staff (apart from the pilot). The doctors and emergency medical personnel might not have great credentials. Medical flights don’t come cheap and you deserve the best. Ensure that you are knowledgeable about the credentials and experience of the crew members.

Experience of the pilot

Medical flights take to skies in tough weather conditions some times. It is essential that an experienced pilot is in control of the aircraft. FAA mandates that the pilot has at least 1500 flying hours under the belt. Some providers have their own standards that are better than the FAA standards.

The medical equipments onboard

Medical flights are often required to take care of midair emergency situations. To accomplish this, they need to have adequate equipments like oxygen, heart monitors, etc.

The communication and coordination

Medical flights need to be in constant touch with the receiving hospital so that all necessary arrangements are made beforehand. Also, the medical flights need to have good communication systems that constantly keep the pilot abreast of weather conditions in the destination. Having adequate communication infrastructure saves crucial minutes when time is of essence.

Of course, people must ensure that their insurance policies cover medical flights so that they are not burdened by huge costs during emergencies that warrant air ambulances.

Is Air Ambulance Transport the Right Option? Answering these Questions Can Help

Deciding whether a patient needs air ambulance transport can be a tough decision, even for a doctor sometimes. In this realm, asking certain questions before deciding on air ambulance transport can help. Below are a few of them.

Does the condition warrant that patient spends least possible time out of hospital?

If the answer is yes, then the patient might be best suited for air ambulance transport as it is quicker than ground transport.

Is a time-sensitive facility unavailable in the current treating facility?

Certain lifesaving facilities or treatments might not be available in the hospital that is treating the patient at the current time. Air ambulance transport might become essential to carry the patient to the nearest medical center that has this facility.

Is the area only accessible through air ambulance transport?

Certain remote areas that have bad or no roads can only reached through air ambulance transport. Air ambulance choppers obviously are preferred during such cases.

Is the weather suitable for air ambulance transport?

The new FAA guidelines for air ambulance transport and the general safety concern for the crew prevents use of air ambulances when the weather conditions are unfavorable.

Is the weight of the patient, equipment and crew within permissible limit of air ambulance transport?

The permissibility of weight might also depend on the kind of aircraft that is available during the emergency. However, weight is a concern that must be addressed.

Is there an airport or helipad to land the air ambulance near the receiving facility?

If the landing facilities are not available, air ambulance transport might not at all be an option. Landing at a considerable distance and carrying the patient to the receiving facility through ground ambulance might defeat the purpose of using air ambulance transport.

Does the ground transport lack critical care support?

Air ambulances usually are extremely well equipped. If the ground ambulance lacks such support, then air ambulance transport might be the only option.

Will use of ground ambulance leave local area with inadequate emergency coverage?

If the answer is yes, then air medical transport might have to be opted so that the medical facility is prepared to meet other potential emergencies locally.

Answering these questions can help make split second decisions, which can mean the difference between life and death during emergencies.

Understanding the Importance of Golden Hour in Air Ambulance World

“Golden hour” is a term that is often referred to in cases of medical emergencies, especially involving an air ambulance. However, if you try looking the term up on the internet, you will be confronted with a variety of conflicting definitions and opinions on it. Here, we try and impress upon you the importance of the term golden hour and tell you why the term needs to be viewed in a broader perspective.

What does the Term Mean for an Air Ambulance Service?

In short, golden hour is that short window of time by which a patient stands the maximum chance of full recovery if he or she receives medical attention. The term is most often referred to in critical cases and the window is usually 60 minutes. It is therefore always the ultimate aim of an air ambulance service to get help within this window of time, when dealing with emergencies. It must be understood that an air ambulance does not always get the full 60 minutes to transport a critical patient, since getting the logistics right can be quite a task. Getting the first-responders, qualified crew, and the staff of the receiving hospital in tandem can prove tough, although an air ambulance service would give it its best to get these aspects in sync.

An Air Ambulance may get a Larger Window of Time Sometimes

If one is to define the golden hour in a wider sense, it would be a time greater than one hour in some cases. Take for instance stroke victims. Here the air ambulance would have about 3 hours at its disposal to get the patient the help he or she needs. In essence, the golden hour need not be 60 minutes literally. It could be a case-by-case urgency, which would be best defined by the treating physician. The golden hour would also determine – in most cases – whether an air ambulance is a feasible option considering the time, accessibility, and costs involved. However, being knowledgeable about the golden hour can help you call for help in a timely manner and save a loved one.

Questions that Define the Necessity of Air Ambulance Service

As the kin of the patient or a patient, you might feel that you need only the best care possible in the quickest possible time. However, if one is to keep the emotions and fears aside and decide purely on necessity, the answers to the questions listed below determine whether you need air ambulance service or not. Let’s take a peek.

Does the condition of the patient warrant that he or she spends only a minimum amount of time outside the environment of a medical facility?
If the answer to this question is as little time as possible, then the patient might need the air ambulance service.

Is a particular test or evaluation urgent or time-sensitive?
If the patient needs a test done urgently and it is not possible to get to the testing facility on time through ground transport, an air ambulance service might need to come into play.

Is the weather condition suitable for air ambulance service to be availed?
Suitable weather conditions are of paramount importance when it comes to an air ambulance service. The wrong weather can put the life of the patient and the crew members in jeopardy.

Is there adequate landing facility near the hospital that the patient is being transported to?
Without proper helipad or air port near the hospital that the patient is being flown to, availing air ambulance service would make no sense. The overall time advantage might be negated after landing if the distance to the hospital is huge.

Is the patient’s condition right for air ambulance service?
There are certain ailments that can exacerbate or turn into critical ones if the patient travels by air. The treating physician would be in the knowhow of this.

Is the air ambulance service equipped enough to address the ailment?
Air ambulance service providers may have several aircrafts with varying medical facilities onboard. The patient can be transported using the medical aircraft only if the facilities onboard meet his or her requirements.

Are qualified crew members available at the moment?
In rare situations, when the mishap is of huge proportions, adequately qualified crew members might not be available. In such situations, depending on the patient’s condition, it might be wise to wait until the crew members are available.

These are the type of questions that treating facilities and air ambulance service providers ask themselves before suggesting or even considering an air ambulance service for a patient. Knowing these parameters beforehand helps the patients and their loved ones to understand the logic behind the medical transportation decisions being taken.