ROLLA (KMOV.com) - It’s a morning Travis Yoakum of Rolla will never forget.
He was getting ready for church when he started to notice pain.
Yoakum said, “Eventually the discomfort went to my chest.”
His wife drove him to the hospital in Rolla but doctors determined Yoakum needed a higher level of care.
Yoakum recalled, “I would say in a span of 15 to 20 minutes the doctor said you may have heart damage. I’m flying you out of here.”
He was transported to St. Louis via Air Methods.
Yoakum recovered from the heart attack and then received a $64,999 bill from the helicopter transport company. He’s insured through Anthem Blue Cross Blue Shield.
At the time of the heart attack in December 2017, Air Methods wasn’t considered an in-network provider with Yoakum’s insurance.
Yoakum says his insurance provider also claimed the air transport wasn’t medically necessary. He says the decision to fly to St. Louis was made by doctors, not him.
He said paying the $64,999 bill was impossible, and “without trying to sound dramatic, my wife and I have discussed bankruptcy at this point.”
News 4 originally spoke with Yoakum in late October.
After News 4 reached out to Anthem Blue Cross Blue Shield, Yoakum said, “In less than a week we heard from them.”
The bill has now been paid, Yoakum no longer owes a balance.
According to Anthem Blue Cross Blue Shield, the provider is now covering emergency medical flights in several states including Missouri.
The change occurred in August, leaving Yoakum to wonder why the bill wasn’t paid earlier.
Yoakum is thankful the situation is now resolved but encourages others to take a close look at their insurance plans.
Anthem released the following statement:
Anthem health insurance is now covering emergency medical flights in several states, including Missouri. A release on Business Wire this week announced that Air Methods, an air ambulance service, has come to an agreement with Anthem to provide the insurer’s consumers with emergency medical services as part of their in-network health coverage.
Before the new arrangement, Anthem Blue Cross Blue Shield of Missouri had no in-network air ambulance providers. There have been widespread reports of patients being billed tens-of-thousands of dollars after being airlifted because their insurance providers had no in-network access to air ambulance services.
The new partnership covers Anthem policyholders in Missouri, Indiana, Kentucky, Ohio, and Wisconsin. Missouri’s Democratic Senator Claire McCaskill, who has a bill to let states regulate medical costs from air ambulances, praised the agreement and urged for more such partnerships in the Show-Me State.
Air Methods also released a statement:
Our mission at Air Methods is to deliver emergency, lifesaving care to anyone who needs it, 24/7/365. Our advanced aircraft fleet and highly-trained clinicians and pilots act as first responders, and in many cases, a critical link between hospitals for patients who need more intensive care.
We are acutely aware of and sympathetic to the stress and financial difficulties large or unexpected medical bills cause many patients, not just those that require emergency air transports. Our healthcare system is complicated, and unfortunately, patients are often caught in the middle.
When a physician orders an air medical transport, it is often because the medical facility does not have the right equipment, staff or expertise. In these cases, our services are requested. Air Methods does not self-dispatch, we only go when we are called.
Unfortunately, claims denials are increasingly common with inter-facility transports. Most health plans see this physician order as requiring pre-authorization and stipulate that patients should be taken to the closest appropriate hospital. Of course, in an emergency situation, patients require immediate and specific care that cannot wait hours or days for a health plan’s pre-authorization. Denials from ‘medical necessity’ are made by health plans with the benefit of hindsight.
Anthem has recently revised their medical necessity policies to encompass more emergency situations. This includes changing their policy in regards to the closest appropriate facility.
However, for patients that are not part of the Anthem network, once this denial occurs, Air Methods is committed to supporting them. Through the Air Methods Patient Advocacy program, we help patients navigate the insurance billing and appeals process and provide them with the information they need to come to a financially sustainable resolution to their claim. However, privacy regulations require patients to initiate communication with their health plans before our patient advocates can get involved.
More broadly, our company is continually working to integrate our critical care in the air services as part of in-network benefits with health plans across the country. In-network coverage offers health plan members a discounted, out-of-pocket payment for qualified services, which varies depending on their plan’s benefits. Staying in-network for their healthcare can help consumers avoid unexpected spending as well as balanced billing, which is the practice of the healthcare provider billing a patient for the difference between the plan’s reimbursement and the medical charges.
In recent months, Air Methods has announced it has gone into network with multiple health plans, including Anthem affiliated plans in Missouri among others. By offering these services as an in-network benefit, we allow members to focus on their recovery instead of unexpected bills.
In addition to our successful patient advocacy program and ongoing in-networking agreements, we are supportive of Medicare re-authorization and state insurance regulators taking a closer look at the causes of large bills, including narrow networks and medical denials.