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Thursday, October 3, 2013
A month ago, Carol Sue Slusser was faced with a huge bill she and her husband, Michael, didn’t know how they could pay. It was $23,495, the unpaid balance after an Anthem payment for her husband’s August 2012 helicopter flight from Carilion New River Valley Medical Center to the University of Virginia Medical Center in Charlottesville.
Glenna Kern of Covington was in a similar situation. After an April 2012 stroke, she was flown from Lewis Gale Hospital in Low Moor to UVa. The bill was $27,686. Anthem paid $7,785, leaving Kern owing almost $20,000. Med Trans agreed to accept $10,000, paid in $25 increments. Kern has been making those payments for more than a year.
Anthem subscriber Paul Witkowsky of Radford suffered a stroke this past April. His unpaid balance from a $23,975 helicopter flight to Carilion Roanoke Memorial Hospital was $18,590.
Today, all three of the patients owe the air transport company little or nothing. On Sept. 19, Carilion and Med Trans announced they had reached an agreement for the air ambulance company to become a network provider with Anthem, the dominant health insurance provider in this region.
A key provision of that agreement was that Med Trans would apply it retroactively to February 2012, when it began operations at Carilion. Though that agreement has not yet been finalized, Med Trans has sent recalculated bills to some patients, including the Slussers and Witkowsky.
The Slussers, who live in Blacksburg, got their recalculated bill Monday. The new balance is zero.
“Justice has been served,” Carol Sue Slusser told me Tuesday.
Witkowsky’s adjusted bill, which reflects a $17,943 “write off — per management” was for $648. He’s paid it.
Kern told me that a Med Trans rep called her, said her debt would be canceled, and that she probably had some refund money due from the $25 per month she’s been paying .
“But I haven’t seen it on paper yet,” she told me.
That may be because the agreement has yet to be signed, despite a news release Carilion and Med Trans jointly issued two weeks ago. Here’s what that Sept. 19 news release said:
“The terms of the agreement will be applied to all flights involving Anthem patients effective immediately. Med-Trans will also apply the terms of the agreement to Anthem patients who have outstanding balances from previous flights and will issue an updated billing statement. Patients who have already settled their bill can contact Med-Trans at 1-866-261-3032 to have their account reviewed.”
Anthem spokesman Scott Golden said: “We are still in active discussions and expect to come to terms.”
When I emailed him the news release, he responded:
“Seems to me like the announcement you cite below was a little premature. …Carilion isn’t one of the contracting parties so I’m a little confused as to why they would be a part of any announcement regarding a pending agreement.”
Carilion spokesman Eric Earnhart referred my questions about the contract to Med Trans. Reid Vogel, the company’s director of marketing, said: “We simply have a large legal document to review, which is well under way.”
The pending new agreement does not cover uninsured patients, he added.
“Patients without insurance are responsible for the bill ; however, we have a charity care policy that offers significant discounts based on a person’s ability to pay,” Vogel said.
And what about patients who have insurance with companies other than Anthem?
Earlier, Earnhart had told me: “It has not been an issue. Other insurers generally pay what is considered ‘reasonable and customary’ rates for emergency air transport without a contract, so patients are not left with an unreasonable out-of-pocket charge.”
Vogel added: “Usual, customary and reasonable payments generally cover the cost of the service and the necessary overhead — which will vary depending on the flight.”
After the Sept. 19 announcement, on Sept. 23, Carolyne Dudding of Christiansburg called Med Trans. Her husband, Don, was flown from Craig County to Roanoke in December after a tree fell on him during a woodcutting accident.
The bill the Duddings got from Med Trans was $20,120; of that Anthem paid $5,581. The balance on the Duddings’ initial bill from Med Trans was $14,538; the company agreed to settle that for $5,184, which the Duddings paid in a lump this past May.
Dudding believes she’s owed a refund of most of the $5,184 she and her husband paid in May.
At Med Trans, “I talked to a lady,” Dudding told me Wednesday. “She said, because Don’s file is in archive, it would take them a couple of days to get it out of archive and they would call me back.”
So far, she’s still waiting for a call.
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