A Personalized Patient CARE ProgramShare On... by Air Methods posted April 19, 2023 As healthcare continues to evolve, the need for patient advocacy has become increasingly important. Patient advocacy is a form of support and assistance that enables patients to navigate the complexities of the billing process with confidence so they can focus on recovery. While there are many ways in which Air Methods can offer patients an individualized experience with their healthcare needs, establishing and maintaining an effective patient advocacy program can be beneficial for both patients and providers. Our patient advocates offer the best experience and resolution through our personalized CARE program, while keeping the patient engaged as partners. For patients, understanding the cost of air medical transport can be confusing and overwhelming. To combat this problem, Congress passed the federal No Surprises Act, which took effect on January 1, 2022. Its intent is to ensure financial transparency and protect patients from unforeseen medical bills. Under the No Surprises Act, air ambulance patients are only responsible for insurance cost sharing amounts, such as copays, coinsurance, and deductibles, without surprise billing. The No Surprises Act keeps patients out of the middle of any billing disputes between out-of-network providers and health insurance plans.Air Methods stepped in to advocate for our transport patients throughout the billing process by creating a personalized CARE program.The four pillars of our CARE program include: Compassion We understand the strain an unforeseen situation has. We strive to assist each patient in maneuvering through the process with ease and compassion. Advocacy Our focus is on the recovery and well-being of the patient’s health. All of us are committed wholeheartedly to making this process as stress-free as possible. Reduction Our financial assistance programs are designed assist patients based on their individual needs and personal financial circumstances.Empathy Empathy is crucial when working with our patients. We understand what our patients are going through and work to alleviate additional concerns so they can focus on their recovery.How the Air Methods CARE Program WorksIn our CARE program, we consider our patients’ individual and often complex financial situations. We devise an innovative billing process tailored to meet each patient’s out-of-pocket costs or cost-sharing amounts. When determining whether a patient is eligible for financial assistance, we consider a wide range of factors including the patient’s debt-to-income ratio compared to their monthly commitments such as rent or mortgage payments, bills, and other expenses. Taking these factors into consideration ensures our patients receive appropriate solutions, tailored to their specific financial situation.Let’s take a look at post transport scenarios for a patient after a claim is billed. Post Transport Billing Scenario File claim with insurance (in-network)A patient will receive an explanation of benefits (EOB) from their health insurance company which advises how much the insurance company paid and the amount of the patient’s cost sharing, if any. Any cost sharing amounts are based on the patient’s health insurance plan and are not determined by Air Methods.File claim with insurance (out-of-network)Under federal law, patients covered under group and individual health plans are protected from receiving surprise medical bills when they receive healthcare services from out-of-network healthcare providers, including those provided by Air Methods. This protection is included in the No Surprises Act implemented on January 1, 2022. Patients who receive air ambulance transportation from an out-of-network provider can’t be charged more than the in-network cost-sharing amount for the same services. Any cost sharing amounts are based on patient’s health insurance plan and are not determined by Air Methods. Assistance with Medicare Part A Medicare Part A does not cover air ambulance transportation. Under our CARE program, our patient advocates will assist the patient by looking at other possible solutions, such as auto insurance for situations involving auto accidents, or help with applying for Medicaid. Assistance with Medicare Part BOnce a Medicare Part B eligible claim is billed and approved, Medicare typically pays 80% of the charges, leaving the patient with only their copayment amount. If there is a secondary insurance, Air Methods will bill the cost-sharing portion to that insurance carrier. If there is no secondary insurance, the cost-sharing amount set by Medicare is the patient’s responsibility. If the patient has a Medicare HMO, balances are dictated by the patient’s plan. Following state rules for MedicaidMedicaid rules and reimbursement vary by state. Patient advocates will work with the patient in the rare occurrence that the patient is responsible for a cost-sharing amount. No insuranceIn instances where a patient has no health insurance, a patient advocate will assist the patient with possible resources. We work with uninsured patients to identify other potential sources of assistance such as qualifying for Medicaid or applying for financial assistance through our CARE program. Once the insurance billing process is complete, the patient is responsible for any cost-sharing amounts (including any applicable copay, coinsurance and deductible). Cost sharing amounts are determined by the health insurance provider and health plan, not by Air Methods. Our Patient Advocacy team can help patients with: Difficulty paying any copay, coinsurance or deductible amount. The process of applying for Medicaid for uninsured patients. Identifying strategies to handle all medical bills, not just air medical transportation bills. We have pulled together some of the most frequently asked questions about the insurance billing process and how the Air Methods CARE program can help. Q: How much will this cost me?A: Depending on the patient’s insurance provider and individual policy, there may be a cost-sharing amount. Copays, coinsurance, and deductible amounts are determined by the health insurance provider and plan, not by Air Methods. In the event of any patient responsibility, our patient advocates are here to assist.Q: Will my health insurance cover my entire bill?A: Air Methods is in-network with most of the large health insurance companies and is establishing new relationships regularly. In addition, following the passage of the No Surprises Act, no patient with out-of-network insurance may be charged more than the cost sharing amount that would have been applied if the air ambulance was in-network. Q: What if I cannot afford my copay/coinsurance/deductible?A: If you can’t afford your copay, coinsurance, or deductible, Air Methods has a CARE program which may be applied depending on your personal circumstances.Q: What if I don’t have insurance?A: Air Methods CARE program applies to uninsured patients as well as those with health insurance.A list of health insurance companies that Air Methods is in-network with can be found on our in-network insurance webpage. For more information on patient advocacy and our CARE program, visit our patient center, call 855-896-9067, or email us at [email protected].