› Forums › General Melanoma Community › A Non-Network Medical Flight was used for Eric
- This topic has 6 replies, 3 voices, and was last updated 13 years, 5 months ago by
KatyWI.
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- November 15, 2010 at 2:53 am
United Health Care only paid $8,000 of Eric's Medical Flight bill leaving us over $15,500 to pay ourselves. The hospital used a company that was not in-network with our insurance. I didn't know this could happen. I thought if you were at an in-network hospital then all services used were in-network. I even asked if the flight was a covered expense and they said yes because it was an emergency, I never imagined they would be out of network!
Does anyone have experience with this? Thanks, JillNEric In OH
United Health Care only paid $8,000 of Eric's Medical Flight bill leaving us over $15,500 to pay ourselves. The hospital used a company that was not in-network with our insurance. I didn't know this could happen. I thought if you were at an in-network hospital then all services used were in-network. I even asked if the flight was a covered expense and they said yes because it was an emergency, I never imagined they would be out of network!
Does anyone have experience with this? Thanks, JillNEric In OH
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- November 15, 2010 at 4:22 am
Jill,
I'm so sorry. How frustrating. Appeal, appeal, appeal…. Get copies of the ER records including documentation that Eric had to be air lifted to a facility that could provide the necessary service. Also, get a copy of the admission sheet at the receiving hospital and the care that was provided upon arrival. Do you know how it was determined that United would pay $8,000? Is that the maximum benefit for emergency transport or is it a PPO and they paid a percentage of an out of network provider? Either way, an appeal is necessary(though if it's the maximum benefit you might not "win"). Most areas don't even have many choices for a medical flight. If one was in an auto accident that required air transport, would you have to make sure an in network helicopter arrived on scene? Ugh!
But just because you are in an in network hospital, all services in that hospital are not necessarily covered. For example, I am a patient at Moffit (in network) but I have to have my lab drawn at a free standing facility (unless I was receiving chemo then I could get it done at Moffitt). But Eric's case was a life threatening emergency. It can be a full time job to learn all the insurance company rules and regs (that change every year). I'm truly sorry that you are dealing with this on top of everything else.
Stay Strong
King
Stage IV 7/05 Liver mets
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- November 15, 2010 at 4:22 am
Jill,
I'm so sorry. How frustrating. Appeal, appeal, appeal…. Get copies of the ER records including documentation that Eric had to be air lifted to a facility that could provide the necessary service. Also, get a copy of the admission sheet at the receiving hospital and the care that was provided upon arrival. Do you know how it was determined that United would pay $8,000? Is that the maximum benefit for emergency transport or is it a PPO and they paid a percentage of an out of network provider? Either way, an appeal is necessary(though if it's the maximum benefit you might not "win"). Most areas don't even have many choices for a medical flight. If one was in an auto accident that required air transport, would you have to make sure an in network helicopter arrived on scene? Ugh!
But just because you are in an in network hospital, all services in that hospital are not necessarily covered. For example, I am a patient at Moffit (in network) but I have to have my lab drawn at a free standing facility (unless I was receiving chemo then I could get it done at Moffitt). But Eric's case was a life threatening emergency. It can be a full time job to learn all the insurance company rules and regs (that change every year). I'm truly sorry that you are dealing with this on top of everything else.
Stay Strong
King
Stage IV 7/05 Liver mets
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- November 15, 2010 at 3:58 pm
Frickin insurance. Don't get me started.
Definitely appeal. It's an aggravating process, but there's no other choice.
Another approach is to work with the medical flight people and try to negotiate with them to accept a lower rate. If they're in-network for another insurance, what rate do they accept from them? See if they will accept that amount from you.
This is the last thing any of us needs, yet we spend hours upon hours fighting with our insurance companies when we should be busy fighting to survive.
Katy'WI
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- November 15, 2010 at 3:58 pm
Frickin insurance. Don't get me started.
Definitely appeal. It's an aggravating process, but there's no other choice.
Another approach is to work with the medical flight people and try to negotiate with them to accept a lower rate. If they're in-network for another insurance, what rate do they accept from them? See if they will accept that amount from you.
This is the last thing any of us needs, yet we spend hours upon hours fighting with our insurance companies when we should be busy fighting to survive.
Katy'WI
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