Key Takeaways
- BlueCross has signed contracts with two air ambulance providers – Hospital Wing and PHI Air Medical – and is nearing a final contract with Air Medical Group Holdings.
- Regardless of network coverage, emergency air transport will be covered, with in-network benefits applied, if ground transport would endanger a member’s life.
- Prior authorization is needed for non-emergency air transportation to be covered.
In 2017, we looked at how air ambulance costs are affecting our members and shared that we are encouraging those providers to join our networks. Since then, we’ve made significant progress on behalf of our members, thanks to three new partners.
Air refresher
The current state of the air ambulance market has resulted in unreasonable costs that continue to escalate. Consider these numbers:
- More than 2,000 BlueCross members required air transport in 2016.
- We paid more than $50 million for those services.
- That figure represents a 73 percent increase in cost over a three-year period, despite just a 17 percent increase in patients.
Nothing is more important to us than the health and safety of our members, but managing costs is also one of our most important roles.
This is why we want to keep you updated about our efforts to partner with these providers.
Five providers make up 95 percent of the air ambulance market in Tennessee. We’ve focused our efforts on bringing these providers into our network, as they cover the majority of our service area statewide. After months of negotiations, three of these providers – Hospital Wing (based in Memphis), PHI Air Medical (based in Sullivan County) and Air Medical Group Holdings (based in Middle Tennessee) – have signed contracts with us.
These three providers represent approximately 75 percent of BlueCross air ambulance transports.“We are excited to welcome Air Medical, Hospital Wing and PHI Air Medical to our network of health care providers,” says Larry Nall, senior vice president of Provider Network Management at BlueCross. “Working to set fair and reasonable rates with these in-network providers will help manage overall costs for our members.”
Flight plan
These new agreements offer welcome relief for many of our members across the state, but our work on behalf of their health – and financial security – is far from over.
“We are working to get the remaining two major providers to recognize and accept the reasonable rate we are offering – five times what they accept from Medicare – that compensates them fairly while providing peace of mind for our members,” Larry says.
If these providers agree to enter our network, they will agree not to bill our members for higher charges than the maximum we allow – and that’s our goal.
Have questions about how these changes to your network affect you? Let our customer service team help. Call the number on the back of your Member ID card between 8 a.m. and 6 p.m. ET, Monday through Friday, to speak with one of our representatives.