Medical helicopter bill is 'a tough pill to swallow'

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Sorry the original didn't post right

Medical helicopter bill is 'a tough pill to swallow'

Posted Thursday, Dec. 03, 2009

By DAVE LIEBER

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lieber Dana Strittmatter was boiling water in her kitchen in July when it

spilled on her leg. After paramedics from Benbrook's Emergency Medical Services

arrived, they called for a medical helicopter from PHI Air Medical, a for-profit

company that operates in Dallas-Fort Worth and elsewhere.

PHI Air Medical flew her to Parkland Memorial Hospital in Dallas. She was

treated and released in an hour, according to her husband, Larry. She had

second-degree burns.

But at the hospital, a doctor and others were angry that she had been

transported by helicopter, Larry Strittmatter said.

One doctor told him that abuse of medical helicopters is a growing problem. The

hospital expected her to arrive by ambulance.

" They were shocked when the helicopter pilot radioed in announcing his arrival, "

he said.

The final bill was $17,500.

The couple's insurance company, UniCare, paid $3,500, saying the situation did

not warrant a helicopter ride because the injury was not life-threatening, Larry

Strittmatter said.

PHI Air Medical sent them a bill for $14,000 with a cheerful " Thank you for

allowing us to be of service! "

" A tough pill to swallow, " Larry Strittmatter said.

On my suggestion, he complained to the Texas Department of Insurance, but that

wasn't right. The agency doesn't regulate pricing. Nor does any other part of

state government — or the federal government, either.

There are no rules about when a helicopter should be dispatched and which

service should get the call. There's no regional dispatch system, either.

With three competing services — PHI, CareFlite and Air Evac Lifeteam — the

region has more medical helicopters than most cities.

Yet abuse of medical helicopters " goes on every day in this country, " said Dr.

Bledsoe, an emergency room physician in Midlothian and a vocal critic of

the air ambulance industry.

Recently, Bledsoe said, a patient was brought by helicopter to his emergency

room with a sore throat.

" The doctor thought it was an abscess, but it wasn't, " he said. " We treated the

patient and sent her home. "

Without regulation, the only hope for the Strittmatters is that PHI won't

aggressively collect the entire amount.

" Some operators are very aggressive about filing lawsuits and using liens to

collect payments, " Bledsoe said.

The air ambulance companies court the paramedics who make the decisions about

whether to use a helicopter. Some companies, he said, offer paramedics small

gifts such as pizza dinners, baseball caps or coffee mugs.

But some patients are getting wise, Bledsoe said.

" We're hearing more stories about people refusing helicopter service, " he said.

It's one more piece of the health insurance puzzle that people should pay

attention to, according to the Texas Department of Insurance.

Larry Strittmatter said he doesn't recall being asked to give consent for the

helicopter ride. His wife, he said, " was drugged and could not have answered

coherently. "

A spokeswoman for UniCare, the insurance company that would pay only part of the

cost, told me: " You're doing a good story because we see cases like this quite a

bit. "

Benbrook Fire Chief Tommy said his paramedics contact a hospital and give

a patient report. Paramedics decide what kind of transportation is needed.

" We assess the patient and determine the best care and expedient method of

transportation, " he told me.

" I understand the situation with the bill. Insurance companies call a lot of EMS

expenses unnecessary and do not dictate patient care. They just decide what they

will and will not pay. "

An executive with PHI Air Medical, based in Phoenix, who asked not to be named

because he wasn't authorized to speak publicly, told me: " It's easy to look at

the case after the fact. The reality is the paramedic is on the scene and must

make a split-second decision. They're driven by what's in the patient's best

interest. "

Dr. Roy Yamada is the North Texas medical director for PHI Air Medical. At the

same time, he has served as medical director for several North Texas cities,

including Bedford, Euless, Hurst, Keller, Mansfield, North Richland Hills,

Pantego and Richland Hills, as well as Dallas/Fort Worth Airport.

In 2007, the Star-Telegram reported that many cities where Yamada trained the

EMS crews also called PHI Air Medical for emergency transports.

The newspaper also reported that, in 2007, a man was flown by PHI Air Medical to

Parkland, even though PHI was not the closest air ambulance.

The PHI Air Medical executive said Yamada had nothing to do with the

Strittmatter case and has no relationship with Benbrook.

When I called Yamada, he said: " I'm over here at one of the fire departments now

giving an exam. So I won't be able to talk to you. Call corporate on that. "

The PHI executive told me that the Strittmatters can still seek a negotiated

settlement with the company.

" PHI is more than willing to talk directly with the patient, " he told me.

Larry Strittmatter sent a certified letter to the company last month asking for

help.

Online extras

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