Even though Pahrump resident Amy Nelson is in the advanced stages of multiple sclerosis, she believes her condition, at present, is the least of her worries.
Nelson, a Pahrump resident since 2007, was a social studies instructor at Pahrump Valley High School for 11 years, until her departure in May 2017.
She is now convalescing in a Las Vegas hospice facility, as the final stages of her medical condition are advancing quickly.
Late last month, Nelson spoke about how she literally landed at the facility, following an examination at Desert View Hospital for severe abdominal pain, vomiting, and bleeding.
Her main worries were the costs associated with being transported by Mercy Air from Pahrump into Las Vegas.
Nelson’s concerns also serve as a warning to others with a similar medical condition, where time is of the essence.
The price tag for the July 11, 2017, helicopter flight, she said, exceeded $52,000.
“I had insurance because I was employed,” she said. “My insurance paid $24,768 to Mercy Air. I’ve been sent to collections for additional costs of $28,063. I strongly believe a discussion was warranted before I was loaded onto a helicopter. Now I’m in hospice care, and bankruptcy is looming. If I had an inkling the chopper journey would cost in excess of $52,000, I would have taken my chances on a road trip to Las Vegas. I don’t know anyone who can afford $52,000 for anything like that.”
Roll of the dice
Additionally, Nelson said she would have taken her chances being transported by ground to Las Vegas.
“I really don’t think the air transport actually saved my life that day,” she said. “I would rather have taken my chances driving to Las Vegas because if I do die, I would like to leave my daughter money to survive. I’m only speaking for myself. I’m not talking about people who have been injured in a car accident or injured somewhere remotely. I was completely cognizant of my surroundings and somebody should have asked me if I would be able to pay for that flight. That way, we could have avoided this whole situation.”
Breaking down the costs
Pahrump’s Mercy Air is a subsidiary of Air Methods Corporation, which provides emergency medical services to tens of thousands of patients each year, according to its social media page.
Efforts by the Pahrump Valley Times to gain a comment from an official associated with Air Methods Corporation and Desert View Hospital were unsuccessful.
As stated within its website, Air Methods Corporation explains what all goes into emergency air medical costs.
The site also noted that just like a fire station, Air Methods’ fleet and highly trained clinicians are always ready to deploy, every moment of the day, whether there is an existing emergency, or not.
“Real-time deployment readiness requires enormous financial resources and ongoing investment,” the site stated. “Aircraft, equipment, highly specialized staff, both clinical and aviation, and ongoing training are only part of the equation.”
No questions asked
Additionally, the company maintains that when it is tasked with saving a life, they deploy without regard to a person’s ability to pay.
Also stated within the website, Air Methods addresses why some patients are transported by air, rather than ground.
“Air Methods responds to every call we receive because a medical professional, such as a physician or first responder has deemed the severity of the situation to be serious enough that air transportation is required in order to get the patient the care they need in the shortest amount of time,” the company stated.
Nelson, meanwhile said she’s not certain about how she will pay for the transportation costs.
“I’m in the hole for a lot of money, but I’m not going to do anything about that, because I’m considering declaring bankruptcy,” she said. “I think death would be cheaper and preferable as compared to losing everything. I’m not saying someone that was injured in a car wreck shouldn’t be transported by Mercy Air, I’m talking about taking advantage of a person with insurance who could have made their own decision, instead of charging me $52,000. That is ridiculous. I am not paying that. I don’t have it, and it’s on principle. Now it has been sent to collections.”
Nelson also said that she would have no problem with being charged a reasonable fee for the flight.
“I’m not saying that I shouldn’t pay for the service,” she said. “$5,000 I can understand, but $28,000 I do not understand. That is a huge amount of money for a 30-minute flight. We live in Pahrump for God’s sakes, so it’s not like we’re living high off the hog. We are not a rich community. As far as giving advice to someone else who is in a similar situation, I really don’t know because everyone has to make their own decisions. All I can really say is don’t hesitate to ask questions. I just wanted to let the public know that it could cost more than $50,000 to get on one of those helicopters.”
The U.S. Government Accountability Office (GAO) is an independent, nonpartisan agency that works for Congress.
Back in 2017, when Nelson took ill, the GAO reviewed data that indicated roughly two-thirds of air ambulance transports for patients with private insurance, were out-of-network.
Generally, insurance only pays for a portion of an out-of-network service, according to the agency’s website.
“In that case, you could be billed for the difference between what the air ambulance provider charges and what your insurance paid, which is known as “balance billing” or “surprise medical billing. Almost all of the consumer complaints the GAO reviewed involved balance bills of over $10,000.”
Additionally, according to the GAO’s analysis of the most complete data identified for air ambulance transports of privately-insured patients, 69 percent of about 20,700 transports in the data, were out-of-network in 2017.
That figure, the GAO said, is higher than what research shows for ground ambulance transports, which were roughly 51 percent in 2014, along with other emergency services, one study noted.
Glimmer of hope
Moreover, air ambulance providers who the GAO spoke with, reported entering into more network contracts recently, which could lower the extent of out-of-network transports in areas covered by the contracts.
“While out-of-network transports may result in balance billing, the data GAO analyzed does not indicate the extent to which patients received balance bills and, if so, the size of the bills,” the GAO said. “In addition, as the GAO reported in 2017, there is a lack of national data on balance billing, but some states have attempted to collect information from patients.
“For example, the GAO reviewed more than 60 consumer complaints received by two of GAO’s selected states, the only states able to provide information on the amount of individual balance bills, and all but one complaint was for a balance bill over $10,000. Patients may not end up paying the full amount if they reach agreements with air ambulance providers, insurers, or both. The amounts of potential balance bills are informed in part by the prices charged.”
Furthermore, the GAO’s analysis of the data regarding transports for privately-insured patients found the median price charged by air ambulance providers was about $36,400 for a helicopter transport and $40,600 for a fixed-wing transport in 2017.
With that said, Nelson noted that she never got a breakdown of the charges for the flight.
“I just have what the original charges of what my insurance paid, and what I am on the hook for,” she said. “I just wish I could have known how much the flight would have been prior to getting on the helicopter. I thought it would be maybe around $10,000.”
In a letter to the Pahrump Valley Times, Nelson also said medical care in 2019 is certainly a ‘hit or miss’ proposition.
“Clearly, it’s a miss for most, based on personal finances,” she said. “If Desert View Hospital wants to airlift you to Las Vegas, ask yourself if death is cheaper or preferable to losing everything, regardless.”
On its website, Air Methods noted that company takes every step possible to make sure they are exploring every payment option on behalf of the patient, whether that’s health insurance, car insurance, or other sources.
“Yet when insurance companies only pay part of the bill, Air Methods is required by law to bill the patients for the rest,” the site stated. “If insurance companies paid fairly, patients could pay very little or nothing at all.”
Contact reporter Selwyn Harris at firstname.lastname@example.org, on Twitter: @pvtimes
A closer look
To read the General Accounting Office’s report on air ambulance costs go to www.gao.gov/products/GAO-19-292
For more on what all goes into emergency air medical costs, as stated by Air Methods Corporation, go to airmethods.com/patientspage/patients
The General Accounting Office’s analysis of the data set with transports for privately-insured patients found the median price charged by air ambulance providers was about $36,400 for a helicopter transport and $40,600 for a fixed-wing transport in 2017.
Check for updates on this story in the Pahrump Valley Times and pvtimes.com