There’s a lot happening in the air medical transport industry currently. With the state lawmakers and the feds trying hard to end surprise air medical billing practices, there is a high degree of lobbying that is taking place both by insurance and air medical transport industry. There is a huge amount of blame game going on. Both parties are trying to pin the blame on each other. Often, you’ll find articles that highlight high bills that patients are compelled to foot and on the other hand, articles that detail the plight of the air ambulance industry and the rising costs it is grappling with.
What is a Surprise Air Medical Transport Bill?
In order to understand what surprise air medical transport bill is, we should adopt an industry agnostic perspective. The problem is not just with the air ambulance industry, it is rampant throughout the medical world. In the United States, unlike other parts of the world, insurance is a matter of network coverage. If a provider is not covered by the insurance company, it is likely that the reimbursement is going to be rejected. This compels the patients to foot the bill all by themselves. This phenomenon, where a person is compelled to pay a medical bill, in spite of having medical insurance, is known as surprise bill. This is what the polity of the nation is currently trying to eliminate.
Why is Tough to Eliminate Surprise Billing?
There are several facets to this. Some air ambulance companies, in the absence of fair reimbursement by insurance industry, simply do not want to come in network. The question arises, “Why?” The answer is obvious – this move paves the way for balance billing where the patient becomes responsible to foot that cost which is not covered by the insurance provider. Then who is to blame? Well, both insurance and air ambulance industries: the insurance industry because it refuses to reimburse a fair amount and the air medical transport industry because it refuses to come within insurance networks. It’s a Catch-22 situation.
Booking an international air ambulance sometimes becomes a necessity when you have to take your loved ones beyond the borders of the country you live in. In a country like the US or UK where the sector is heavily scrutinized and regulated, the chances of things going wrong is fairly small as long as you are financially sound enough to foot the bill. However, money is not the only criteria when you want to book an air ambulance in countries where regulations are slightly lax. In this context, one must understand that the industry is not that mature in most parts of the world, especially developing countries.
Fraud is a Possibility when You Book an Air Ambulance Across Borders
Take for instance, the case of an air ambulance company in the Indian capital of New Delhi. It is believed that an air ambulance company was booked by the authorities for purposely defrauding people after taking their money in advance and not offering medical flight services. The authorities only acted after the company had duped several people. One such person ended up losing his critically ill father owing to this fraud. He had paid the company in advance to transport his father from Johannesburg to India.
The Precautions One Must Take
- Accreditations are a good way to begin. Checkout whether the air ambulance company that you plan to hire is accredited by well known organizations. For instance, a company like REVA has multiple accreditations and is known to fly several patients internationally and has been doing so for quite some time.
- Another great way to check this out is by going through testimonials. Social medial channels like Facebook are a great start. See what other people are saying about the company to gain confidence.
- Referrals also matter. If you know someone who has used such a facility speak to them.
Finally, always keep in mind that internet should only be the first line of research. There is no substitute to speaking to air ambulance services first-hand.
The aviation sector – which air ambulance industry is a part of – is a huge contributor to CO2 emissions globally. In fact, about 2.5% of the global CO2 emission is attributed to the sector. Even more concerning is the fact that the impact of high-altitude emissions is twice as much when compared to ground-level emissions. Digital connectivity that provides an IP to each air ambulance can play a part in cutting down this carbon footprint. The technology, along with digital connectivity that generates and transmits data in real time, can make wonders. Let’s take a look how.
Better Air Ambulance Flight Planning
Turbulences owing to adverse weather conditions can cause a lot of fuel burn. They often necessitate emergency landings, change in altitudes, route deviations and so on. All of these actions cause fuel to burn at a higher rate. Imagine a situation where all this data is passed on to the air ambulance well in advance through a network of digital connections so that alternate flight routes can be mapped well in advance and seamlessly. It would also preclude the possibility of mid air mishaps and help in offering better service and comfort to patients onboard. Most importantly, it would bring down the costs related to fuel and also the associated CO2 emissions.
The Need to Carry Contingency Fuel
There is a direct correlation between the weight of an air ambulance and the fuel that is needed to carry it in the air. As a precautionary measure against unforeseen circumstances that can necessitate longer flight time, most air ambulance flights carry contingency fuel. This adds to the weight of the aircraft and in turn, burns more fuel. Data gleaned through connected devices and satellite imagery in real time can lift the veil off such uncertainties and lessen the need for contingency fuel.
Air ambulance services are usually viewed from a narrow lens. In other words, we associate medical flights with emergencies at a very granular level where individuals are rescued. We tend to ignore that they are a huge part of relief and rescue efforts at a government level across the globe. When natural calamities and manmade disasters are epic in proportion, air ambulances are the last hope for survival sometimes. Of course, they do not work in isolation and are a part of the bigger emergency response ecosystem. However, sharing of data, managing them securely and keeping the entire picture transparent and tamper-proof can be a challenge. This is something that blockchain technology can get right.
Blockchain Technology is More than Bitcoins
What most people fail to understand is that Bitcons or cryptocurrencies are just one application of blockchain technology. The real benefit is enablement of a system in which data flow is seamless, transparent and unchangeable. For large government organizations across the world, this is a huge plus because emergency situations are often soft targets for unscrupulous exploitation. Blockchain can keep make it virtually impossible for anyone to tamper with data and consequently the relief funds.
What is Blockchain Technology and How Can it Help Air Ambulance Services
We already know that blockchain brings to picture an immutable record of transactions. For air ambulance services, the biggest benefit is the trustworthy connection it brings to the emergency response ecosystem.
The answer to what the technology is all about: Blockchain is essentially a network that brings a large group together into a system where no change can be made in the dark. The only way to make a change is to make it apparent to the rest of the stakeholders in the network. Also, there is no going back to modify data. In all, this brings transparency to a group where the flow of information is truthful at all times.
Wearable technology can play a vital role in streamlining emergency services, especially when it comes to air ambulances. Imagine this situation: John is out on a mountaineering expedition with a small group of adventurers. Unfortunately for him, there is an avalanche and he is stuck neck deep under the snow. Injured, he is unable to move. The only thing that’s keeping him alive is the hope that air ambulances get to him soon, but he is not even in a position to make a call. Yet, it only takes 15 minutes for an air ambulance to be dispatched, and in the next 30, he is on an air ambulance. How was it all possible?
Wearable Devices Can Contact Air Ambulances
It sounds like science fiction that a simple watch or a device that you wear can actually call air ambulances during emergencies and that too without any intervention from you. How can a device so small be so intelligent? The answer: it is a mix of logic and technology. Here’s how it works – the wearable device continuously monitors the person wearing it. His vital signs such as his heart beat, breathing, temperature, etc, are monitored. When there is a drastic drop in any of the signs; for instance, heartbeat, the device requests the person wearing it to intervene. If he does not intervene, the device assumes that the person is in trouble and automatically sends a signal to emergency services for a response.
There is More to Wearable Technology
Let’s go back t John who is stuck under the snow. The biggest challenge facing air ambulances would be his location. Thanks to the device, it provides the precise location coordinates to the first responders. Not just that, it continuously sends across his vital signs so that they can gauge his health condition on an ongoing basis.
What makes the device so intelligent is a combination of sensors programmed to monitor the vital signs and its ability to communicate using mobile and cloud technology.
Several countries around the world have progressed much further than the United States when it comes to drones. Take for instance, the East African Nation, Rwanda. The country has been using drones in lieu of air ambulances to transport medical necessities during emergencies. Of course, these might not be as efficient as air ambulances yet, but the day is not far when drones would be much more useful. Rwanda is a country where roads are far from being ideal and drone technology is seen as a respite. Come to think of it, rural America too can benefit from this concept.
The Prevalence Gap between Air Ambulances and Drones in the US
The US skies are dotted with a lot of airplanes, which of course include air ambulances. The drones on the other hand can be a hindrance. In fact, there have been several instances where drones have proven to be a nuisance for air ambulances and commercial flights. The necessity, therefore, is for a regulation that strikes the right balance. Also, general drone enthusiasts should also proactively show more responsibility. The other area that needs a closer look is innovation in the field of medical drones where they can at least play the part of supplementing efforts of air ambulances.
The Government Encouragement for Medical Drones
The congress, at the present time, is in the process of considering a bipartisan legislature called Drone Backlog Reduction Act. The intent of this legislation is to encourage innovation and ensure safety of medical drones. Once that is achieved, it will become easier to get the approval of the Federal Aviation Administration to use medical drones more extensively. At the current time, the use of drone is also severely limited by the norms laid down by the Federal Aviation Administration. If all goes well, the people will benefit from innovations in medical drones immensely.
Well this might not come to you as a surprise because you might have witnessed this yourself. According to one survey conducted by Kaiser Family Foundation, about 40% of US citizens have revealed that their families have received a medical bill despite being covered by medical insurance. This is a growing problem for the country as insurance companies are seen restricting the number of providers in their networks. Of course, out of network providers are not covered by insurance companies. In this context, the question arises, is it the same logic behind huge medical flight bills that people across the country are witnessing?
Medical Flight Bills and Insurance Network
A majority of industry experts believe medical flight service providers willingly stay out of insurance networks. The reason is simple, they lose the freedom to charge what they feel is fair for their services. It is also felt that there is a huge disparity between what the medical flight industry believes is a fair payout and what the insurance industry pays. The middle ground, it seems, is something that has not been achieved so far. The issue has not gone unnoticed by the lawmakers. However, the opinion is divided as to who is responsible for the huge bills.
Efforts by Lawmakers to Bring Down the Bills
Several attempts have been made to limit the amount that can be charged for medical flight services. From trying to ban balance billing to compelling air ambulance companies to come under insurance networks, several innovative efforts have failed. The reason behind this is the Airline Deregulation Act of 1978. Designed to create a competitive environment to keep the price of this essential service down, it precludes the state governments from intervening in the matters of air ambulances. Only the Federal Government is authorized to make changes.
Bystanders are often left wondering how to handle emergency situations. If the medical necessity is grave enough to warrant a medical flight, live streaming the emergency situation to the first responders through video streaming can be quite helpful. With the connectivity and mobile enablement that the world enjoys today, making this possible is not a tough ask. All it would take is an app that covers privacy, consent and similar concerns. The chances of the injured or ill getting immediate help becomes easy. Bystanders can get instructions from qualified first responders.
Addressing the Privacy Concern
The app will certainly help the patients immensely; however, there can be privacy concerns. The solution – treatment, if needed, can be delivered after an expressed consent from the patient. Moreover, the video need not be recorded or stored on either ends, both the patient and first responders. In fact, the kind of application is already being used in United Kingdom. A dedicated solution like this to emergency response centers, can do a lot of good. Since every medical flight covers a huge amount of distance, people, especially in rural America, can benefit significantly.
The Need for Medical Flight Can be Gauged
In situations where there is no qualified medical professional to make a decision whether the patient needs emergency medical flight services, the mobile app can be of immense help. The ‘medical necessity’, which plays a huge part in insurance approvals, can be determined quickly and effectively so that the patient is free of such worries from the word go and where applicable, an informed decision can be made.
Integration of such an app widely is important. If each player in the medical flight industry comes up with a unique platform to execute this, it would be a disaster. What the industry needs is a common platform so that execution becomes easy.
The Airline Deregulation Act of 1978 has found mention far too many times recently. Every attempt by insurance commissioners and insurance industry has been successfully countered by the air ambulance transport industry, thanks to this act. At the outset, the act itself seems arbitrary considering it takes away the power to control prices by the democratically elected state governments. Then why was this bill introduced in the first place? This is the question that comes to mind often. It was originally passed so that competition can be encouraged. However, it is questionable whether this intent is still being served in the current industry context as prices are simply shooting up. In an ideal competitive world, the prices must be well controlled.
FAA Reauthorization Act of 2018
It must be noted that only the Federal Government can make changes to the existing ADA of 1978. Considering the growing voices against the act, the government enacted FAA Reauthorization 2018. While some were hopeful that it will make drastic changes to the exiting act, it was not to be. The new act limited itself to making provisions to appoint an advisory committee to take a closer look at the air ambulance transport industry and the financial burden on the patients. It has no powers to implement any changes and is limited to offering advice only.
Balance Billing and Air Ambulance Transport Industry
Balance billing continues to be a problem. The healthcare insurance industry, it looks like, refuses to change its reimbursement model for the air ambulance transport industry. It has remained unchanged for over two decades now. On the other hand, medical flight companies are refusing to conform to the prevailing reimbursement rates and adamant against going under insurance networks. The result: balance bills that are not covered by insurance are being thrust upon the patients and they are being compelled to foot bills that amount to thousands of dollars. A solution does not seem at sight, at least at this juncture.
Air ambulance services are dispatched only when the emergency is dire and time is of critical nature. Many a times, the only contact with a patient or a victim is over the phone. As a consequence response professionals in emergency call centers are forced to rely entirely on their experience to determine the condition of the patient. Most times, the patient himself is unaware what is wrong with him. For instance, a person having a cardiac attack might not even realize that he is having one. The response professionals are forced to rely on qualified guess work. All this can change with the introduction of artificial intelligence technology.
Offering Better Air Ambulance Services with Artificial Intelligence
Imagine a situation where analyzing patient condition is done by an algorithm that continuously learns by analyzing patterns in data. It eventually becomes capable enough of offering diagnostic suggestions based on the description of symptoms, speech pattern, breathing frequency, etc. It would go further prompting the response professional to ask the right kind of questions to aid in understanding what the patient is going through. Wouldn’t that be amazing? It is no longer a science fiction; this is now a possibility, thanks to artificial intelligence. If implemented, it can take air ambulance services to a whole new level.
How Does Artificial Intelligence Learn
As mentioned earlier, it is all about forming patters through a combination of cases. All that an artificial intelligence algorithm would need is call recordings made by patients to air ambulance services over a period of time. It would have been pre-programmed to find patterns of symptoms to come up with a diagnosis.
It is all about data and analyzing it. The added advantage is that this data becomes a ready base to study populations, injury patterns (especially in road accidents) so that safety measures can be bolstered to increase safety. The applications are several and are only limited by one’s imagination.