Tag Archives: Balance Billing

A Quick Guide to Know US Air Ambulance Industry Better – Frequently Used Terms

There’s a lot happening in the US air ambulance industry at the current time with people opposing high bills, law makers coming up with newer regulations, and medical flight companies demanding more accountability from the health insurance industry. These happenings will, ultimately, affect the common US citizens. Here’s a glossary of sorts that allows you to understand certain points pertaining to the US air ambulance industry.

ADA of 1978 – the act that governs US Air Ambulance Industry

ADA stands for Airlines Deregulation Act. It was enacted in the year 1978 and has since governed the aviation industry in general. This is a federal act and prevents the states from interfering in the affairs of US air ambulance service providers when it comes to price, route and service.

FAA Reauthorisation Act

The abbreviation FAA stands for Federal Aviation Administration – the body that regulates aviation services in the US. The Reauthorisation Act is currently under consideration. If passed, it will give the states the ability to interfere in the matters pertaining to price, route and service, but only when it comes to the US air ambulance industry. The Act is a response to people’s demand to the government to look into the skyrocketing medical flight bills.

In-Network Air Ambulance Service Providers

Most US air ambulance companies have an understanding with insurance providers to cover their services, at least in a given location. These medical flight companies are considered “in-network” by the insurance providers, and mostly, full coverage is given if their subscribers opt for these medical flight companies.

Balance Billing

In most instances insurance companies only cover a part of the air ambulance bills. The medical flight companies are forced to cover the remaining money from the patients directly. In other words the balance amount is billed to the consumers.

ADA Pre-emption

The ADA of 1978 is clear that states cannot interfere in the affairs of US air ambulance companies when it comes to price, route and service as mentioned above. If an air ambulance company is sued with regards to any of these, it enjoys pre-emption from such lawsuits.

US Air Ambulance Memberships

Most US air ambulance companies offer annual memberships at a nominal fee. These members enjoy complete insulation from balance billing. The membership is an additional layer of protection over and above the health insurance.

Taking a Medical Flight? Know what ‘Balance Bill’ is

More often than not, we hear about skyrocketing medical flight bills that families are forced to pay. While it is natural for such families to feel victimized, having some prior knowledge about insurance coverage can prove helpful. If you are among those people who feel all they need to do is pay health insurance premiums, sit back and relax, here’s some news: your most basic health needs might not be covered. This mostly happens when the medical service provider is out of network.

Out of Network Medical Flights can Be Expensive

Take the case of 8-year-old Ben Millheim who met with an unfortunate accident fracturing his skull. The injury necessitated using a medical flight service to a hospital about 100 miles from the site of injury. While the boy survived and recovered well, his parents are still reeling under the $32,000 medical flight bill. Unfortunately for them, the medical flight service that they had used was out of their insurance network. As a result they are now liable to pay the service provider the ‘balance bill.’ In other words, they have to now shell out of their pockets the amount that their insurance provider has refused to pay the medical flight company for the reason that it does not come in their network.

It’s Almost Always a No-win Situation for Patients

Life-threatening injuries leave little room for checking whether a particular medical flight service provider is covered by the health insurance. While insurance companies flatly refuse to bear such expenses, it has been seen that air ambulance companies usually offer a discount to such patients. Plus, several states in the United States have passed legislation to limit balance billing; however, some states like Missouri have not. It must also be noted that there is no federal regulation that governs balance billing, leaving people vulnerable.