Effective immediately, any Anthem patients who are air-lifted in any of Lifeguard's three helicopters will not see bills as high as those who needed the service over the past year.
"We know that there has been some concern in the community," says Paul Davenport, vice president of Emergency Services at Carilion Clinic, because in the past year, some patients have received large bills for helicopter medical transport; in some cases, patients got a bill for more than $20,000 for that flight.
"Our aviation partner, Med-Trans, through lengthy negotiation with Anthem, has now come to an agreement with Anthem," Davenport says. "This was always in the forefront of our discussions with Med-Trans about our desire to continue an Anthem agreement from our previous contract."
"Anthem and Med-Trans are large entities covering a lot of difficult geographies, so that adds some complexities to what we are trying to get accomplished," says Rob Hamilton, chief operating officer for Med-Trans.
Hamilton said the negotiations have taken "a good year."
As for the Anthem patients with those high medical bills from the past year, Hamilton says, "We want to engage with each one of the patients that has been affected by this out-of-network status on an individual basis."
Anthem is the only health insurance carrier to ever have a contract with Carilion Clinic's Lifeguard 10, even before Med-Trans took over last year. Since other health insurance companies provided higher reimbursement rates, a contract wasn't needed.
Davenport emphasizes above all else the Lifeguard crew is most concerned with providing efficient and effective care.
From now on, all Anthem patients will only be billed for the deductible and co-pay amounts applicable under their insurance plan.
When we checked with Anthem about this situation, Scott Golden told us Anthem will consider this agreement official when both contracts are signed, which is expected next week.
The following statement comes from Carilion Clinic:
The terms of the agreement will be applied to all flights involving Anthem patients effective immediately. Med-Trans will also apply the terms of the agreement to Anthem patients who have outstanding balances from previous flights and will issue an updated billing statement.
Patients who have already settled their bill can contact Med-Trans at 1-866-261-3032 to have their account reviewed.