|Date:||November 04, 2016|
|Author:||Brett Shipp & Mark Smith|
DALLAS -- Colton Lightfoot of University Park has had a few flips and spills on his motocross bike before. But the one the 17-year-old suffered last May on an East Texas track became a serious emergency.
"It was just right off the start, then crash, and then I got run over,” he said. “That's just what I've heard. I don't remember anything."
But his father Royston remembers everything.
“They got him on a flat board and stabilized him,” Lightfoot said.
He will never forget the drive to the nearby hospital in Sulphur Springs, the CT scan revealing a fractured vertebra, and a doctor's recommendation to transport his son by air-ambulance helicopter to a hospital in Dallas.
"Emotionally, you're a wreck,” Lightfoot said. “You see your son or daughter fly off in a helicopter, it's not good."
The family has video of Colton lifting off in the helicopter servicing the Sulphur Springs hospital. At the time, his parents were concerned about one thing -- the safety of their son.
Two weeks later, they were shocked when a bill arrived from the air ambulance company
"My wife said, ‘You are not going to believe this air ambulance bill,’” Lightfoot recalled. “We open it and it's $58,000.”
Their insurance carrier said it would only cover $15,000 of the 74-mile flight. The Lightfoots have to pay the rest, $43,000, on their own.
The air ambulance company, Air Methods, the nation's largest air ambulance company, was an out-of-network medical service provider. That means they didn't have a contract with insurance carriers with an agreed-upon price.
Air ambulance medical services in the U.S. are unregulated and that allows them wide discretion on charges. When LightfootGoogled “Air Methods,” he found out he was not alone.
"I started reading through all these (complaints) and that's when the light went on… (they are taking advantage of) a loophole,” he said.
According to Dallas aviation attorney Ladd Sanger with the Dallas law firm Slack & Davis, the practice of billing out-of-network for air ambulance services is legal, but can be financially devastating for patients financially unprepared for the costs.
"The air ambulance companies, because they are called out in emergency situations, don't want to be in network with anybody because they don't want to have their fees capped at a reasonable and necessary level,” Sanger said.
Sarah Oelke of Oklahoma City remembers when her infant son, Garrett, was having trouble breathing hours after he was born.
"I was a little concerned,” Oelke said. “He didn't sound great."
He needed specialized care at Children’s Hospital at the University of Oklahoma Medical Center 11 miles away.An Air Methods helicopter assigned to Children's Hospital was recommended to transport her newborn.
"I'm not thinking anything about the bill to come,” Oelke said.
Her son turned out to be fine. But the $28,000 bill came due and has haunted her the past two years.
Insurance paid only $5,100, leaving her with a $23,000 tab. She says she will have to take out a loan to pay.
Oelke, a nurse practitioner, believes medical providers like Air Methods are wrong.
"Ethics, morals and informed consent are huge,” she said.
Oelke is just one of eight other Oklahomans suing Air Methods, accusing them in court documents of an "inflated pricing scheme and refusing to discount prices to those who have no ability to negotiate."
Her attorney, Alex Yaffe, is seeking class action status, saying there are hundreds of former patients across the U.S. who are being overcharged.
Another class action case alleging Air Methods overcharged patients is pending in South Carolina.
"It's expensive, but it can be done way less expensive, and way more efficiently than what's happening with these for-profit companies,” Yaffe said
Air Methods, and its parent for-profit company, Rocky Mountain Holdings, declined to comment on camera due to pending litigation, but provided WFAA-TV with this statement:
"We understand that every patient's individual, financial and health insurance coverage circumstances are unique, and our team is dedicated to partnering with every one of them. Air Methods has a charity care program in place to allow us to reduce patient financial responsibility. Our team is here to help.”
On the other end of the spectrum is Care Flight, a non-profit air ambulance operating in North Texas.
Medical Director Robert Simonson says between $12,000 and $15,000 per trip is a normal and reasonable fee. He says billing patients like Lightfoot for nearly $60,000 is questionable.
"People are getting bills that are more expensive than their hospital bills once they got to the hospital,” Dr. Simonson said. “That begs somebody to take a look at the industry and say, ‘Is this appropriate or not?’"
If you are hit with an outrageous air ambulance bill, experts say: