Air ambulance flights save many lives each year. Because air ambulance providers and insurers cannot always agree on a fair price, many air ambulance providers remain out of network. These out-of-network charges — often in excess of $50,000 — may result in “surprise” out-of-pocket bills for tens of thousands of dollars for your employees.
Roughly 75 percent of air ambulance flights involve Medicare and Medicaid patients – and reimbursement is usually capped at around $6,500. Air ambulance providers have indicated that this reimbursement amount is too low, given the high cost of maintaining 24/7 readiness and having to provide service for the 85 million Americans who live more than an hour from a Level 1 or Level 2 trauma center. With nearly one-fourth of rural hospitals closing since 1990, air ambulance transport time and costs have been driven higher.
Healthcare Horizons offers fee negotiation services — working on behalf of our self-insured clients – to reduce fees for services rendered by out-of-network providers.
Our familiarity of the industry along with long-standing professional working relationships allow us to approach air ambulance providers with a fee negotiation agreement that allows fair reimbursement for services rendered that is often much lower than the full billed charge amount. A successful negotiation provides savings to the self-insured plan and eliminates any balance billing to patients as the providers agree to write-off the difference between billed charges and the negotiation amount.
Healthcare Horizons’ out-of-network provider negotiation fee is based solely on a percent of savings achieved – if we are unable to achieve a successful negotiation, there is no fee to our clients.
To dive deeper into the topic of out-of-network air ambulance fee negotiation, read Healthcare Horizons’ article in July’s Self-Insurer Magazine: Why Self-Insured Employers Need to Negotiate Air Ambulance Rates.
The Difference is in Knowing.
To learn more about our approach to healthcare claims auditing or out-of-network provider fee negotiation services, visit Healthcare Horizons, or reach out to us at hhadmin@healthcarehorizons.com.
Randy King is president of Healthcare Horizons Consulting Group, Inc. The company is one of the nation’s leading healthcare claims auditing firms, focused exclusively on self-insured employers since 1999. Healthcare Horizons has recovered millions of dollars for its clients through auditing and air ambulance negotiations for some of the world’s largest employers.
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