christian bolling courtesy cynthia bolling

Christian Bolling, then 9, fractured his skull, broke his wrist and two bones in his lower leg, and smashed his nose in a fall in April 2018. Then his parents got the bill for his ambulance flight to the hospital — $24,000, on top of the $12,000 their health insurer paid.

A southwest Roanoke County family who tangled with an air ambulance company over a $24,000 bill is tangling no longer.

Cynthia Bolling said she and her husband, Courtney, have agreed to settle the debt with Med-Trans Air Medical Transport for $4,400, payable by the end of June. That’s roughly 18 percent of what the company had claimed the Bollings owed from an April 2018 incident in which their young son was badly injured.

“I’m happy to be able to put this behind us,” Bolling told me Friday. “But it’s infuriating to know that I’m not alone in this struggle.”

After I wrote about the family and the bill last month, Bolling has heard from others in this area facing the same problem.

Christian Bolling, then 9, was injured last year during a family outing with his mom, dad and sister. They had hiked up to Devil’s Marbleyard in southern Rockbridge County.

As they began the hike back to their car, Christian fell off an embankment and landed on his face 25 feet below.

He fractured his skull, smashed his nose and broke his left wrist and two bones in his lower left leg. Rescue workers extracted him from the backcountry accident site and put him on a helicopter to Carilion Roanoke Memorial Hospital. Cynthia flew with him.

The family’s health insurance policy through Aetna covered all but roughly $6,000 of Christian’s hospital and rehabilitation treatment. But the flight was billed separately because Med-Trans is a private contractor that operates Carilion’s Lifeguard 10 helicopters.

Med-Trans has no provider agreement with Aetna in Virginia, which means the air ambulance service is considered an “out-of-network” provider. Although Aetna paid Med-Trans $12,000 for the 34-mile flight, the Bollings were shocked to learn they were responsible for the balance of the $36,484 bill.

In the May 21 column, Med-Trans spokesman Reid Vogel said that 75 percent of the patients the company flies are “underinsured,” meaning the company loses money on those flights.

Basically, it means people who can afford to pay get overcharged to make up for the losses incurred by patients who can’t pay.

The Bollings spent the better part of a year unsuccessfully appealing to Aetna to pay more, but those appeals were denied.

They spent more months appealing to Med-Trans. In the meantime, Cynthia Bolling researched the air ambulance industry and discovered similar cases across the United States.

In May, Med-Trans offered to cut the bill to $10,000 if the Bollings paid within 30 days. Courtney Bolling works in sales and Cynthia is a physical therapist. They didn’t have that kind of money, she said.

At that point, Cynthia took to Facebook to vent her frustrations. That’s how I learned about their problem.

“The financial strain that this could put on our family has caused me more anxiety than his accident,” she wrote in a public post.

“Like most of middle-class America we cannot afford to pay this nor do we feel we should have to pay such an exorbitant amount.”

Cynthia ended that post by noting that the family wasn’t seeking donations. “It is more important to us that you share our story so that other people are aware of the deplorable practices of air ambulance companies across the country,” she wrote.

Friday, she told me the $4,400 settlement was hammered out via haggling that resembled negotiations in “buying a car.” That played out over a few weeks.

Cynthia said that when she told a Med-Trans representative in May that the family couldn’t afford a $10,000 settlement, the rep replied that Cynthia was free to make a counter-offer. The Bollings offered $2,000, Cynthia said.

“I kept asking to talk to a supervisor,” Cynthia told me. She said she finally got one, and the company re-countered by agreeing to accept $9,000.

“I said, ‘There’s no way,’ ” Cynthia recalled. “I countered with $4,000.”

On May 31, a Med-Trans rep called her and countered again, saying the company would accept $4,400, Cynthia said. She agreed.

Friday, I contacted Vogel, who said Med-Trans could not comment specifically on the Bollings’ bill, because the company doesn’t have a signed release from the family.

“Our patient advocates always work with patients and families regarding any balance to pay based on their ability to pay,” he wrote in an email. “Every family is in a different financial situation so amounts paid also vary based on discussions between patient advocates and the family.”

Cynthia told me about the settlement early last week, before she had it in writing from Med-Trans. The written agreement arrived in the mail Thursday — and it had a nondisclosure clause. Oops!

“I called them and said, ‘Hey, listen, I already reached out to the reporter [me] and told him,’ ” Bolling said. “They had another guy call me back. He said, ‘Just don’t say anything to anyone else.’ ”

So don’t tell anyone about this, OK?

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Dan Casey knows a little bit about a lot of things but not a heck of a lot about most things. That doesn't keep him from writing about them, however. So keep him honest!

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