March 18, 2016
The cost to take a medical helicopter in an emergency is quickly soaring in Texas and there’s nothing to stop companies from charging patients as much as they deem fair.
Just ask the Brock family.
In 2013, four-year-old Isaac Brock suffered severe burns from a fire in Burnet, Texas. After his father rushed him to Cedar Park Regional Medical Center, a company called, PHI Air Medical, transported Isaac to a San Antonio hospital specializing in pediatric burn patients.
“We get a phone call and I see on the caller ID Cedar Park Hospital, and your heart just sinks. You know something terrible has happened,” said Jackie Brock, Isaac's mother.
PHI charged the Brocks $40,206 for the 43 mile helicopter ride. Charges included a $18,964 flat fee, plus $247 per mile.
To put that in perspective, $40,000 dollars could fly you around the world nine times and you’d still have money leftover, according to Delta.com. It costs about $4,170 to fly from Austin to Atlanta, London, Mumbai, Tokyo, Honolulu, Los Angeles and then back to Austin.
According to records obtained from the Texas Department of Insurance, PHI’s air ambulance base price fees have increased 127 percent, from to $11,492 in 2010 to $26,177 in 2015.
PHI declined on-camera interview requests.
“We are not subsidized by any governmental agency in any way. We simply are providing a service with a cost that’s fair to run a business,” Brad Deutser, company spokesperson, told KVUE on the phone.
Deutser wouldn’t discuss Brock’s bill, but said, "It’s extraordinarily rare when a patient has been sent to collections. It means they did not work with us to resolve the cost.”
PHIissued this statement to KVUE:
“PHI Air Medical is called to transport and care for patients in significant need. These patients are flown because a physician or EMS professional has determined that it is medically necessary. We have a legal obligation to respond in these situations, without knowing of a patient¹s ability to pay. Our primary concern in these moments is the safe transport and critical care for the patient in need. It is only after the safe transport that we reach out to a patient or patient¹s family regarding payment for our services, during which time we provide significant support through our Patient Advocates. This dedicated team is available to answer any questions, appeal on the patients¹ behalf to insurance agencies and to help with any special consideration with resolving their bill. We work with and for each and every patient that is willing to work with us to determine the best and most fair manner to resolve their bill, based on their individual circumstance. PHI Air Medical has one of the most compassionate billing and collections practices in the industry. Our individualized special consideration program often results in a reduced bill, a payment plan, or in some situations, the elimination of all charges. Our whole reason for being is to support our patients during and after the flight, thus, it is difficult when, in the rare circumstance, they choose not to participate and we are left with no choice but to involve outside support to assist with collections. It is unavoidable and disappointing, especially when we can help them dramatically reduce their share. We know that when patients do work with us, we have been able to produce very favorable outcomes with and for them.”
In January, the company sent Brock’s bill to collections, seeking $30,000. Late Thursday afternoon, PHI settled with the Brocks for $5,000.
“I don’t think they would have done this without the Defenders getting involved,” Jackie Brock said.
Air ambulance fees will likely continue to increase. In 1978, congress deregulated the commercial airline industry, which includes medical helicopters, allowing companies to charge as much as they want.
Not all medical helicopter companies operate the same way. Dallas-based Care Flite is one of the oldest non-profit air ambulance programs in the nation.
“Were a non-profit and therefore were not going to try to figure out the most expensive way to do it, were going to try to find the most efficient and inexpensive way to do it,” said CEO James Swartz..
Swartz claims CareFlite doesn’t go after patients who are unable to pay.
“They’re asking for help. They’re not asking for a lawsuit. They’re asking to help save their life,” Swartz said.
According to state insurance records, air ambulance fees in Texas make up the single largest category of active medical fee disputes by a wide margin.
WHAT'S CONSIDERED A FAIR CHARGE?
It depends on several factors, like where the patient is picked up, but Medicare has a benchmark on what it considers fair reimbursement.
For example, PHI charged the Brock family $247 per mile to fly. Medicare would have reimbursed PHI for $22 per mile for the same ride.
So, PHI billed 1,112% above what Medicare considers fair market price.
The most visible air ambulance organization in central Texas is STAR Flight, run by Travis County Emergency Medical Services. Its transports cost significantly lower. STAR Flight’s base price runs $3,900 for county residents and about $105 per mile.
HOW TO FIGHT YOUR BILL
If you or your insurance company is unable to reach a settlement, there are companies, likeSentinel Air Medical Alliance,available to help negotiate for you.
This story is part of a joint ABC News investigation with ABC TV stations throughout the country. Go here to see the ABC News' investigation.