The medical flight industry is as much interested in finding a solution to the surprise billing problem as the rest of the United States. The reason for this is obvious. It is a PR nightmare for the industry that is amid media and public outrage as their steep bills often surpass hospital expenses, driving people to the brink of bankruptcy. The problem is compounded when private insurance companies are involved. However, it makes sense to understand the insurance dynamics before pinning the entire blame on the medical flight industry.
Medicare, Medicaid, and the Medical Flight Industry
The insurance reimbursement rates of Medicare and Medicaid have remained unchanged for over a decade now. This puts a lot of cost burden on the medical flight industry. In essence, the reimbursements are not adequate to cover the costs. The air ambulance companies, which are mostly for-profit, simply are incapable of bearing this cost, especially considering the high cost of maintenance. This additional cost burden is eventually offset by transferring it to the individuals who are privately insured and this is the root of the problem.
Private Insurers and the Air Ambulance Industry
Private insurers are often seen denying the claims citing the lack of medical necessity to employ air ambulance services, even though medical flight services are recommended by the physicians in the first place. The scenario puts the patient in a very difficult situation as the decision to avail such services is not in their hands. However, there is one exception. Air ambulance services that are in-network with the insurance companies do not face this problem. It is important to note here that close to 70% of the service providers are out of network. The necessity, therefore, is to negotiate a reasonable reimbursement rate and bring as many medical flight companies within the network as possible.