Questions arise about medical helicopter cost after family left with big bill
STERLING HEIGHTS, Mich. – Imagine you're a parent standing in an emergency room with your child fighting for life. If doctors told you your child needed to be flown to another hospital, would you even consider the cost?
That's the situation the Belz family of Sterling Heights found themselves in during a medical crisis involving their 14-year-old daughter Amanda in March 2014.
"She was constantly breathing, fast rapid breathing, couldn't catch her breath," said Amanda's father, Raymund Belz.
Amanda was rushed to the emergency room at Beaumont Hospital in Troy, suffering from several conditions at the same time.
"They said she had the flu, pneumonia, staph infection," Raymund Belz said.
Things escalated quickly.
Doctors at Troy Beaumont said Amanda needed more help than they could give.
"They told me it was so critical that she can't go by ambulance because she may not make it. So, they had to put her onto a helicopter," Raymund Belz said.
Amanda was flown to Beaumont Hospital in Royal Oak, which has a pediatric ICU.
Her family said they were told it was 50/50 on whether their daughter would make it through the first night.
Recovery, then shock
Thankfully, Amanda did recover. It was a slow process that took months.
Just weeks after the scare, the Belz family faced another challenge, a financial one.
The first bill for that helicopter ride landed in the family's mailbox. It was more than $23,000 and "out-of-network," per the family's Blue Cross Blue Shield policy.
"The first thing we're thinking of is they're gouging us. That's way more expensive than it should be," Raymund Belz said. "It was a six-minute flight and it was $23,600."
Where did the bill come from?
Who charged the Belz family so much, and why? Beaumont Hospital hires a company called PHI Air Medical, which is based in Phoenix.
Experts tells the Local 4 Defenders PHI is one of the top three players in the medical helicopter business.
"They collected $300 million in revenue and $47 million in profit in 2014, which is up 26 percent from 2013," said Jon Hanlon, the founder of Research 360. He analyzes publicly traded companies like PHI and said PHI is not the only company raising rates for emergency medical transport.
In the Belz's case, Blue Cross Blue Shield paid a portion of the bill, more than $6,300, which is actually the amount it would have paid for an "in-network" rate. The insurance company gave the Local 4 Defenders a statement: "Because PHI Air Ambulance has not signed a contract with us, we cannot prevent them from charging unreasonable additional amounts to families."
Belz is disappointed Beaumont is using an "out-of-network" helicopter service.
"I go to Beaumont specifically because it's 'in-network' and I don't expect to have to pay an 'out-of-network' service, and here I get this huge bill," said.
Response from Beaumont
"We don't want parents to be stuck with a big bill," said Dr. Bassam Gebara of Beaumont Children's Hospital in Royal Oak. He sat own with Defender Hank Winchester to speak about why doctors use the medical chopper. He said it's very rare to use the helicopter for such a short trip, but the chopper offers some invaluable services.
"They can provide life-sustaining or life-supporting measures in the helicopter that may not be able sometimes to provide in other ways," Gebara said.
Winchester asked if there are certain questions patients or families can ask before someone is transported by a helicopter.
"If they think the child is not sick enough, and maybe they could go by ground, they may actually bring this up," Gebara said.
He said medical staff are aware of the high cost and it's a difficult balancing act.
"You can't have somebody who actually becomes bankrupt because of something like that," Gebara said.
The doctor couldn't answer specific questions about the cost in this case, but Beaumont released a statement saying in part, "The helicopter serves as a 'flying intensive care unit', 'staffed with highly-trained medical professionals'.... and is reserved for the most critically ill or injured patients."
Hanlon said when insurance companies don't pay, families are on the hook for the cost.
"In many cases, they're being sued and they end up filing for bankruptcy, they've had liens put on their homes, it's really a disaster in my opinion," he said.
Response from PHI Air Medical
PHI Air Medical declined our invitation for on-camera interview and released a statement, saying in part, "Our company has structured its fees to remain competitive ... while still maintaining the safest, most comprehensive, and advanced aircraft, care, and services available."
And, "We have designed our special consideration program to help individuals who need assistance paying their share of the bill."
The Belz family is currently considering all their options. They tell the Local 4 Defenders they've considered the special consideration program, but it requires them to share extensive personal financial information with PHI, and they are not comfortable sharing that information.
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