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Leigh Campbell got quite a shock in the predawn hours of April 3: his wife, Heather, 27 weeks pregnant, went into early labor.
The couple, who live in Ray Brook, rushed to the Adirondack Medical Center in nearby Saranac Lake. But because that hospital lacks a neonatal intensive-care unit, their midwife called for a helicopter to bring Heather to a hospital in Burlington, Vermont, on the other side of Lake Champlain.
The good news: Heather avoided a premature birth. As of Friday, she remained in the hospital waiting to bring her baby to term.
But the Campbells are still dealing with the aftermath of another shock: two days after the medical emergency, they learned that the bill for the 25-minute helicopter flight was $59,999. And Heather’s insurance carrier would cover only about $370. The service provided by the helicopter company, LifeNet, was “out of network” and therefore not covered by her health-insurance policy.
Large bills for out-of-network services aren’t uncommon and have long been a source of contention between insurance companies and their customers. But there’s an added twist, said Campbell, a graphics artist who began researching the air-ambulance industry after receiving the bill. Because they describe themselves as air carriers, the companies say they aren’t subject to price restrictions. The federal government deregulated airline rates in the late 1970s.
Campbell, an Army veteran who served in Iraq, has been driving back and forth from his home to Burlington daily. Now, with the stress of the lengthy commute, the 31-year-old worries about his wife’s health. And then there’s the $60,000 helicopter bill.
LifeNet is a subsidiary of Air Methods, a Colorado company whose representatives didn’t respond to phone calls or emails on Friday.
The company has been the subject of several critical stories in national media that have called attention to its high prices and its tendency to pursue payments through bill collectors or legal action. Its home page describes its personnel as “Defenders of Tomorrow” dedicated to “quality of care to patients & safety in aviation.” The page also lists the company’s stock price on the NASDAQ exchange.
LifeNet is a relative newcomer to the North Country, arriving in the Watertown area several years ago to fill a void that opened when the Fort Drum Army base stopped providing free emergency helicopter airlifts. There had been a program at Fort Drum known as Military Assistance to Safety and Traffic, but it was moved in 2007 to Fort Lewis in Washington State.
Air Methods has operated elsewhere in New York, sometimes drawing controversy. One patient, New Paltz lawyer Diana L. Kidd, counter-sued the company after it brought legal action to collect a $36,646 bill for flying her from Catskill to the Westchester Medical Center following a motorcycle accident. According to press reports, Kidd contended that a regular ambulance would have gotten her there in less time than the 115 minutes she said she was billed for. Kidd couldn’t be reached on Friday.
The Campbells’ bill breaks out the charges into mileage (51 miles for $23,062) and the “Helicopter Rotor Base” ($36,937). Eileen Mowrey, a spokeswoman for Adirondack Medical Center, would not comment on the Campbells’ case, but she said people in an emergency need to take whatever option is available at the time.
The region has a volunteer group of paramedics who can fly with services such as State Police helicopters, but those helicopters weren’t available on the morning Heather Campbell went into labor.
Driving from Saranac Lake to Burlington, a 71-mile road trip, takes about two hours. However, individuals familiar with rescue services said getting a helicopter in the air from its base near Watertown, then flying 112 miles to Saranac Lake, loading it, and traveling on to Burlington can take close to two hours as well.
State and health insurance officials said the Campbells have several avenues they can pursue. The Affordable Care Act, also known as Obamacare, provides an extra level of potential appeals regarding charges racked up from non-participating providers. And state Health Plan Association spokeswoman Leslie Moran noted that since last year, consumers in New York can use an independent arbitrator to appeal payment issues for out-of-network charges.
Leigh Campbell’s sister started a GoFundMe campaign to help pay for the helicopter bill. As of Friday night, it had raised more than $8,600.
Photo from the GoFundMe page for Leigh and Heather Campbell.
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General inquiries about the Adirondack Almanack should be directed to editor
as I’m sure they know, it’s worth appealing.
I suppose this is where I say “Huzzah for capitalism and our for-profit sick care system” and denounce (insert menacing music) socialized medicine.
Absolutely sickening… A couple could charter a private plane to fly from Saranac Lake to Geneva Switzerland for under $9,000…. I looked it up.
A better plan would be to move to Switzerland where the government regulates the health industry to prevent this kind of abuse.
Terribly disgusting. Makes me hate being a human being or wonder if they are freaking human. I’d tell em they can settle for what u can give them and a thank you so much for possibly saving a life or they can screw themselves go to Cort spend more money and win a judgement they won’t ever collect. Balls in your Cort
So the question is, where was North Country Life Flight, and how did this couple manage to get hooked up with these rip-off artists? I’ve never heard any complaints about Life Flight.
North country life flight was the first call made but they did not have a pilot available at that time.
You get what you pay for…
Adirondack Med Center should pick up the excess bill; if a road ambulance could drive to Burlington in 2 hours and the combined wait and flight time was 2 hours (a fact the Med Center should have been aware of) somebody could have and should have exercised judgement.
I agree. Also – who is the ‘midwife’? This article says the midwife made the call, so she should take ownership of the overcharge. Is the midwife associated with Adirondack Medical Center?
It would be great if there was a state/county/local fund to help out with cases that fall between the cracks like this. There should be a negotiated maximum charge to the out-of-network patient. Small towns always seem to be interested in attracting more residents, but this is the price (literally) that one often has to pay to live in a remote community. Lack of emergency health services is rarely considered when one is young and healthy.
To me, this flight service seems to have found a niche for preying on people who fall between the cracks – all perfectly legal in our ‘health’ system. It would be interesting to know if they are on ANY insurance panels because of these practices. This is what riles me about our 3rd party health system. The entire in-network / out of-network system seems to me to be nothing more than a way for insurance companies to maximize already high profits.
All of the naysayers, please feel free to say no to air transport. Just don’t whine/sue when your family member dies mid transport. To the one talking about taking a private plane to Switzerland. Nice. Stupid, but nice. Does that flight include an advanced trained paramedic and RN in attendance, with a pilot with thousands of hours of flight experience just to be considered? And the two hours of road time vs. Two hours of flight time? The danger time is the time out of the hospital, away from hospital facilities. That’s two hours ground time- provided there’s no traffic, construction, weather, or other delays. When I call for a helicopter for transport, the cost is the absolute last thing I consider. Who’s available, how fast can they get to me? Any considerations outside of that, people start to die. But again, feel free to tell me you want ground transport only. After 30 years in EMS, watching you save money you’ll never spend, because you died on my stretcher, won’t affect me in the least.
Eric- the outrage isn’t over a call to use air transport. The price of the flight doesn’t have anything to do with how much it actually cost. I’m pretty sick of the argument that we should expect capitalism to step in and offer us a better priced option if the price is really that obsurd. The for profit health “care” industry proves time and again there is no genuine concern for our brothers & sisters unless there is $ to be made.
What if they charged $1 million? Would that be OK too? This is a prime example of where capitalist free Enterprise and health care don’t partner very well.
“Does that flight include an advanced trained paramedic and RN in attendance, with a pilot with thousands of hours of flight experience…”
Well, no, but then again it’s to Switzerland. Something tells me one could get the paramedic, the RN and the experienced pilot for quite a bit less than $60 grand, but perhaps you’d care to point out how it really isn’t gouging? I’d be interested.
OK, let’s figure costs. Flight paramedic, flight RN, pilot all on duty 24/7/365. Ground crew running ongoing maintenance, lots of it required on helicopters. Billing office staff. Office staff. Medical control physicians. Boatloads of malpractice insurance for the most sue happy country on the planet. Liability insurance. Fuel costs. Drug costs. Supply costs. Ongoing training costs. Aircraft costs. Now add in insurance companies that don’t pay the whole bill. Operating policies include automatically launching the helicopter to certain accident calls for higher risk for injury( such as on the northway) as the call comes in. if 15 minutes later the ambulance arrives and states there is no need for the already enroute helicopter, they cancel, absorbing those wasted fuel costs. They provide ongoing safety education for local fire and EMS agencies at no cost. They provide a presence at health fairs and annual high school DWI mock crash drills at no charge, to help educate the public. How else would you like to pay for it??
Eric,
Perhaps this is how the service can afford “…ongoing safety education for local fire and EMS agencies at no cost. They provide a presence at health fairs and annual high school DWI mock crash drills at no charge, to help educate the public.” They simply gouge patients to pay for their ‘benevolence’. I call it advertising for their company passed on to the consumer, which unfortunately is SOP in this type of a health system.
Unfortunately it is a necessary practice for providers to charge patients fees that are quite high, but this assumes they have insurance coverage which denies some of the charge and pays a large percentage of the remaining balance. So the provider gets a negotiated fee and the patient pays a negotiated fee. But much of this goes out the window with emergency and out-of-network services when decisions are often made under duress..
IMO, as long as the patient was informed of the approximate out-of-pocket expense of $50k before they agreed to it, there shouldn’t be much of an argument. But if the service was called without their knowledge and authorization, then they should have some recourse with the provider who arranged for the service. Hopefully in this case a lower negotiated fee between the parties can be arranged.
Quick question. You’ve just been in a massive car wreck. Your abdomen is rock hard on the left side, leading me to believe your spleen is ruptured. I’m pretty sure your pelvis is fractured, too. your heart rate is 136, blood pressure 80/40. You are in severe decompensated shock. Ground time to a regular hospital, where surgical staff will need to be called in, is an hour away. (As I’m your medic, I’m basing the scenario where I work). The helicopter landed while we were cutting you out of the wreck. Flight time to a trauma center, where a full staff is waiting to receive you, is 35 minutes away by air. Ready for an in- depth conversation about costs of the transport? Right now. Of course, they have no idea what your insurance covers, we in the field are more concerned with silly little things like taking care of you. Ready to discuss it? think you’ll say no?? Good luck.
But this simply wasn’t the case in this scenario, and this is the case I am discussing. This was a pregnancy where much of this should have been discussed in advance – especially living in a remote area. Early labor is always a possibility and some thought should have been put into the “what-ifs” beforehand. Likely they were aware of a reasonable air shuttle by a different company that their insurance would cover much of the cost. When it was found out they would have to go with a different out-of-network provider, were they even asked if they wanted to use it? As I said, we don’t know the details.
As a former employee for 23 years of Empire Ambulance, which does these transports for Saratoga and Glens Falls Hospitals, let me give you the general rundown on these calls, to explain the dynamic nature of them. First of all, there are few predictors of who might have premature labor. Generally, a woman having a normal pregnancy suddenly may “not feel right”, have cramping, or have contractions. She goes to the hospital where she is followed for OB services. If she is found to be in labor, the first thing is usually an injection of terbutaline. If this doesn’t work, she is started on IV fluids and IV magnesium sulfate. When this is started, transport to a hospital with a NICU is started. Now, this is the scary part. You have no idea during that transport if the meds are going to work. I’ve seen them work nicely, I’ve seen them have absolutely no effect whatsoever. Keep in mind, the decision to transport is usually 30-45 minutes from when the patient arrived at the hospital. it goes quick. Now, the transport time is critical. My closest call was a flying trip down the northway from Glens Falls to Albany Med. 42 minutes road time. She delivered 2 minutes after she got in the room. When my daughter was born at 25 weeks in Albany Med, there were 13 people, 8 of them doctors, in the room for my daughter and wife. In an ambulance, one medic and one OB nurse (maybe) for both mother and child. Anything that can shorten that trip is a good thing. And my work was on the flat, wide open northway. Picture trying to transport on the roads of the Adirondacks.
Eric, it sounds as if you’re saying that if you’ve got a patient in a near-death situation, the company is justified in charging whatever they feel the market will bear. As you can see, most of us don’t feel that that is right. What is the actual cost to provide the service? What is a reasonable profit? Someone has suggested that $25,000 is a more typical charge. $60,000 is 240% of $25,000. Is there a reasonable justification for that difference? What is it?
The number pulled up is $25,000 average for a transport; however, this wildly varies as to where you are. If you get a system such as Baltimore’s Shock Trauma, where helicopters transport nearly all critical patients in the city’s outlying areas, it’s not unusual to have 6-8 flights a day. At $25,000 each, that’s $150,000 to $200,000 a day. For a smaller base, such as Potsdam, figure 1-2 calls a day. at $60,000, you’re talking $60,000 to $120,000 per day, still trying to cover expenses that generally don’t change, as itemized in one of my earlier posts. In some areas also, the helicopter is owned by the hospital. This leads to your helicopter flying your patient to your hospital, getting you an exclusive patient supply, and instead of generating a transport bill which insurance may not cover, the bill can be integrated into other coverable expenses.
Outrageous. For profit US medicine marches on. When will we ever get smart about a fundamental right to reasonably priced medical care?
Many hospitals in our region are either using or looking into using this air transport company, LifeNet. They get a commission on the bill.
iPhone’s provide an electronic “medical alert bracelet” that anyone can access. There’s a place in mine where I’ve entered “Not paying for helicopter.”
Probably won’t do any good, but it felt good.
While it’s not a bad idea to start the Go Fund Me campaign, I wouldn’t want those greedy SOB’s getting the $60,000. Perhaps it would be better spent on a good lawyer.
Sorry the story leaves out what special care they were being rushed to at the neonatal intensive care unit. When a woman has her water break early like this and she goes into labor they usually give her some pills and tell her to stay in bed. I know this from experience with my wife in a neonatal intensive care unit. Why couldn’t she just be driven in an ambulance to Burlington?
One has to keep in mind that pre/post-birth malpractice suits are very common, so healthcare workers in this specialty are particularly careful about avoiding litigation. Another sick part of our current health system.
People love opportunities like this to dis the US healthcare system. But even (especially) a single payer system is not going to pay for unnecessary stuff. That very well might be the case here. It sounds like a midwife called for the chopper. Maybe they should have checked with the OBGYN? I just think there may be more to this story than an expensive flight that the insurance company didn’t want to pay for.
I think you’re missing the point, Paul. The question is whether this flight should have cost $60,000–irrespective of the medical treatment rendered.
Yes, it sounds pretty outrageous. I get that. But at the same time the insurance company must cover this sort of thing if it is medically necessary and my guess is they are not paying 60K. That is why I suspect there is something strange going on here that isn’t covered.
Paul,
There are plenty of opportunities to ‘dis’ the healthcare system. As a provider in this system, we often see it from a different point of view. When people are able to be legally gouged by opportunistic ventures such as this with no help from their profitable “insurance” company, it is shameful. US 3rd party insurance companies make their profits by taking people’s premiums and denying as many claims as possible. It isn’t the healthcare per se that is the problem, it is the 3rd party system.
I agree – there may very well be other pertinent facts in this case we do not know of. For instance, was the patient informed what the out-of-pocket cost might be before consenting to the flight? Were her options spelled out? Unfortunately, when one is in pain and concerned for both her life and the baby’s, it is basically like signing a contract under duress. Hopefully there will be some legal options to help with some of their cost.
According to Mr. Internet it looks like the average cost for a helicopter medical transport is $25K and the insurance companies usually cover it if it necessary. If insurance was paying they would probably pay the average. This average may be for flights that are not so distant like from the freeway to the hospital.
It would be nice if we could have clarification that the mid wife was authorized to order a life flight under these circumstances?
If you look at all the training and how these things are equipped (not to mention insurance) I am not that surprised that costs are in the tens of thousands. This is not like you are just reimbursing the guy for helicopter gas or whatever the thing runs on.
Agreed.
A health care summit needs to happen in the next Congress.
This affects us all, even legislators, so let’s get going.
There has to be common ground on this issue!
Some people who are outraged might put zero value on the baby yet born.
Possibly, but we don’t know all of the details. The baby’s position or other factors may have also put the mother at risk.
Despicable. I hope and pray that I never have to use LifeNet. Adirondack hospitals should boycott them.
The hospital should be responsible. Midwife, MD. Why does it matter who called? They were in the hospital where an MD made a diagnosis. Why didn’t the hospital warn them that they were not covered? They know everything about your insurance the second you give them your info. To me it sounds like someone not technically affiliated with the hospital made the call to keep the hospital technically off the hook for doing so, but to me it sounds like there must be a kickback system in place. Follow the money.
These people got a great benefit from the emergency service, so why shouldn’t they pay for it? Should I pay for it? Or you? No, this couple should.
ThirdG, I think the general feeling is that they didn’t get $60,000 worth of service, AND they had no idea they were going to be charged such an exorbitant fee. Perhaps you think it’s perfectly OK. More power to you.
A few things. EMS is expensive. EMS is the most dangerous job outside of the military per US DoL. You have to pay people to take those sort of risks. We are trying to keep someone alive. Air Ambulances certified by NYS DoH are an ambulance and are supposed to be covered under ACA; destination choice is made by the crew for the most appropriate for the patient. Networks do not matter since we gave no way to know which hospital is in your network. Go with the appeal and get you legislators involved.
Where is Life Flight in all of this? Isn’t this the purpose of Life Flight, the non-profit?
You get what you pay for…
http://abcnews.go.com/US/sky-rage-bills-debt-lawsuits-follow-helicopter-medevac/story?id=37669153
Yes my daughter and son in law are from Saranac Lake and she went in the plane because the helicopter couldn’t fly. Their cost is around $46,000. They actually welcomed their 23 week 6 day son Christian Thomas Field in March 30. They will not inly have the plane cost but months of NICU cost.
It is an outrage that in the richest and most highly industrialized country in the world that a young working couple has to be put through this! A bill for $60,000??!!
Even in a relatively impoverished (and much demonized) country like Cuba this would be cost-free. Why should people have to resort to the kindness of strangers? And by what right does an air lift company exploit people’s moments of desparation and gouge them mercilessly?
And Leigh is an Iraq vet, for crying out loud! I wouldn’t blame him if he wondered what sort of society he was risking his life for.
We witnessed a helicopter rescue several years ago at Moreau Lake State Park for an injured mountain biker. I think he had a broken ankle – nothing life-threatening. He was arguing with the EMS guys on scene – literally lying on the ground with a map showing them how it could be done – trying to convince him to carry him down because he didn’t want to get stuck with a helicopter bill. The EMS did not want to physically haul him several miles through the woods and over-ruled him. He was lucky – a state helicopter was available (which means the flight was free). But he literally was not given a choice and could have been stuck with a $60,000 for a trip to the ER for a broken bone.
Actually, the state police would be your only option here. Lifenet helicopters are not equipped for rescues like that. And as far as carrying the victim for miles when another option was available- would you want to do it? Our job is to treat the patient and get them safely from point A to Point B, and back in service for the next call. As an EMS captain, if you tell me you want my people to risk themselves carrying you through the woods because you don’t want to pay a bill, I will politely suggest that you find your own way out. This is not Burger King, you don’t get it your way.
Wow, just too bad if you don’t happen to have a spare $60 grand lying around, eh?
Glad I do my hiking in the Adirondacks where the DEC rangers will haul you off the mountain for free!
adkDreamer says: “I agree. Also – who is the ‘midwife’? This article says the midwife made the call, so she should take ownership of the overcharge.”
>> When I first read this in the newspaper my initial thoughts were ‘Did this couple request this service? If not then they shouldn’t be charged.’
The story above states “their midwife called for a helicopter to bring Heather to a hospital in Burlington, Vermont…”
I don’t recall reading this in the news story perhaps I overlooked it. I agree with adkDreamer on this one though the fee is still quite excessive. Welcome to America!
In rebut to Eric Fitzgerald’s impassive response Adkdave says:
“The for profit health “care” industry proves time and again there is no genuine concern for our brothers & sisters unless there is $ to be made.”
Yes and there’s no excuse for it in a civilized society.What does this say about us?
What it says about us is that we’ve not been able to mount a strong enough political movement to get these vultures out of the health care system.
Eric says: “Flight time to a trauma center, where a full staff is waiting to receive you, is 35 minutes away by air. Ready for an in- depth conversation about costs of the transport?”
I see your point Eric but still… It’s a sad state of affairs no matter how much you try to justify your conviction on this matter. I think about all of the money we spend on munitions that are deployed in foreign lands to outright kill,maim and impair victims by the tens of thousands (more depending on which conflict we’re talking about.) Little boys and girls losing their lives and limbs,losing their mommies and daddies. We can come up with the money to support these atrocities yet when it comes to helping out our own brothers and sisters in dire need we lay the bill on them. It only makes sense! Whomever is proud to be american raise your hands.
Bellota says: “When will we ever get smart about a fundamental right to reasonably priced medical care? ”
Obama tried to do something some few years ago Bellota but ‘you know who’ would have nothing to do with it because he was not one of them. So we’re stuck with Obamacare which does help a lot of people but it is not what it could have been had the opposing party tried to work together with him. Now all these few years later we’re hearing now and again how some republicans have a better plan than Obamascare but you must wonder why they couldn’t work together with him initially to come up with a better plan? Because that was then and now…it’s an erection year.
Boreas says: “When people are able to be legally gouged by opportunistic ventures such as this with no help from their profitable “insurance” company, it is shameful.”
Should read “When people are able to be legally gouged by opportunistic vultures…”
Could have been my spell-checker…
It is not clear that they have been “legally” gouged yet. Wait for the rest of the story to unfold.
Sounds reasonable.
I have one question. If ( or more likely when) the insurance company pays…What are they gonna do with the 60k in gofundme? Hmmmm
The company is out-of-network for this couple (and apparently for everyone else, too). I would say that the odds of them coming through with the full amount is about zero.
Interesting that you aren’t wondering what the company is doing with their outsized profits.
The NFL is not for profit. Adirondack Med Center is not for profit yet the CEO make 700k a year. I’ll bet you double your paycheck BCBS pays.
Incidentally the “free” helicopter is not equipped or trained to transport high risk OB and routinely denied complex patients. And the “free” helicopter has 2 employees, one is the CEO and the other is the only paid flight nurse and they make very very nice salaries. Oh and the are married.
Guess the Almanac wants a bleeding heart story. The deleted my post that contained facts.
Like all this stuff in social media. The insurance company will pay in this case and it will go away.
Any guess on quarterly earnings for BCBS or the salary of the not for profit CEO of Adirondack Med Ctr?
Uh, Nick, your idea that the insurance company will pay is based on what, exactly? Notice that LifeNet argues that one of the reasons they have to charge so much is that many insurers DON’T pay. And I’m not picking on LifeNet’s CEO’s pay– I think the vast majority of American CEO’s pay packages are way too high, especially in the non-profit sector.
Nick, nobody deleted your comment.
John Warren
Editor
It is easy for everyone to sit on their couch and point fingers at everyone involved. It’s life nets fault! its the hospitals fault! its the insurance company’s fault! It’s even the couples fault! They should have known better and figured out if their insurance company was going to pay– in the heat of the moment!
There are hard working north country residents working on these helicopters and airplanes to support their families. How many lives do these people have to save before they get any recognition?
Everyone just wants everything to be free. But at the same time nobody wants to pay taxes. “I want everything to be free- but I’m going to vote for Trump- and I want to keep my free health insurance, food stamps and housing.” What a joke. Running a 24/7 air ambulance isn’t cheap.
If we didn’t have these people serving our region, patients wouldn’t make it to where they need to be in time. It’s that simple. But keep complaining and trying to drive life net away. Idiocy!!!!!
This really isn’t fair! Yes the helicopter workers need respect, but that’s not the point at all. Nobody wants everything to be free, either. But to be hit by a bill that’s far more than most working people in a year is unacceptable. A few hundred, or even a couple of thousand, would hurt a lot, but not be newsworthy. $60,000 is devastating.
It’s not asking too much for a fair and reasonable health care system in the most advanced country in the world. Every other industrialized country has one, with cheaper overall costs and better outcomes.
I do think the insurance companies are at fault here. They need to start paying up. I’d like to see a statistic of the chance an average person will need a helicopter evacuation in their life. It’s low…. insurance needs to pay for at least one ride in full.
I mostly agree with you. A few hundred or a couple of thousand isn’t reasonable for this type of service though.
Even 15k would be reasonable for an individual to pay out of pocket but 60k. How do you scrap together that amount of money? Most individuals assets wouldn’t liquidate to that much. Then what should they do? Yes, the insurance company should pay more but can they pay 60k? Insurance companies have tried to contract but LifeNet won’t accept the negotiated rate of around 13k. If the cost of LifeNet is too high for the regions residents and/or insurance companies to shoulder out of pocket, then yes, they should go away or atleast have a realistic method for individuals to pay the bill rather than lawsuits with lien judgements and wage garnishments.
Many of the personal bankruptcies every year are due to healthcare issues – and many of those were insured individuals. An insured individual is expected to get advance permissions, determine in/out network status, determine if every provider accepts their insurance, determine if they can afford an airlift or extreme procedures, and decide which normal procedures they can even afford – all possibly while under pain/duress or even UNCONSCIOUS!!! One would think the 3rd party-payer system was set up for legal extortion.
Seems like the hospital is slightly at fault here. They know the ins and outs of insurances and should have gotten a prior authorization where they would have realized it was an out of network issue and the Campbells would be responsible for this huge bill. At at least this couple would have known before getting that shock.