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Thursday, September 19, 2013
Anthem health insurance subscribers need no longer worry about facing huge out-of-pocket costs for helicopter flights if they’re flown to Carilion Roanoke Memorial Hospital by its air ambulance contractor.
More than 18 months after beginning operations at Carilion, Texas-based Med Trans Air Medical Transport has reached a provider agreement with Anthem, the dominant health-insurance company in Western Virginia.
The agreement was announced Thursday afternoon, and concludes more than a year of negotiations between Med Trans and Anthem, said Rob Hamilton , the chief operating officer of Med Trans.
It will serve as great solace to anyone flown to Roanoke Memorial since February 2012, when Med Trans began its Roanoke operations.
That’s because the agreement is retroactive and will cover any Anthem patient flown to Carilion hospitals since then, said Eric Earnhart, a spokesman for Carilion.
Until now, Anthem has been paying only a small fraction of the total flight bill, and Med Trans has been billing patients for the balance, sometimes to the tune of $18,000 or more, according to patient bills shown to The Roanoke Times
“The goal is to make everybody whole, so that no one ends up owing more than what would be their appropriate co-pay and deductible under their Anthem plan,” Earnhart said. “This goes back to February 2012.
Hamilton declined to say how much Med Trans would discount its flights under the Anthem provider agreement.
“We’re satisfied at that fact that this is something we’ve been working on for a long time,” he said.
One of the beneficiaries of the agreement will be Paul Witkowsky, a Radford University English professor who earlier this year was flown to Roanoke Memorial Hospital after suffering a stroke.
The bill for that 35-mile flight was $23,975. Anthem noted its allowable charge for the flight was $6,032, of which Witkowsky would be responsible for 20 percent.
After Anthem paid its portion, Med Trans billed Witkowsky for $18,591. He found that outrageous and brought the matter to the newspaper’s attention.
“The most appropriate thing I can say is, it’s about time,” Witkowsky said Thursday evening.
His balance is outstanding, and people in Witkowsky’s position can expect to be rebilled by Med Trans under the new agreement with Anthem.
But even patients who have already paid outstanding balances to Med Trans may benefit from the agreement, Hamilton said. Anyone who has paid such a balance should call Med Trans directly at ( 866) 261-3032 to have their accounts reviewed.
Until Med Trans took over the air ambulance program, Carilion flights were provided by Air Methods, which had a provider agreement with Anthem. For that reason, out-of-pocket costs to patients weren’t an issue.
At the time Carilion switched contractors to Med Trans, there was an expectation that it would reach an agreement with Anthem, but that didn’t occur until now.
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