Air Evac International

Thank you for the opportunity to respond to Mr [redacted] complaintMedical Logistics Management (“MLM”) will not speak to the subjects of the complaint not associated with the air ambulance transportSpecifically, MLM has no opinion as it relates to issues with Carnival, services offered at the hospital, calls made to the hospital, alleged information provided by the hospital during telephone calls, or decisions made by the consumer of which MLM was not a party.As it relates to the service rendered, MLM provided an air ambulance transport for Mrs [redacted] as indicated by the consumerAs a service to its patients, MLM submits all insurance documents for the consumer and on the consumer’s behalf advocates for coverageIn this case, MLM did not require the consumer to make any payments in advance of the services being rendered, but instead, secured terms through contractsUnder the terms of the insurance plan with the consumer, the insurance carrier determines whether or not it will pay for servicesIn this instance the insurance carrier did a medical necessity analysisThe consumer is correct that the consumer does have out-of-country air ambulance servicesThis is the same information MLM received in advance of transportHowever, a decision to pay for services is not done in advance of the transport unless a pre-authorization is requested and such request was not done on emergency Services such as the service provided to the consumerAccordingly, the consumer would not have been apprised of whether the insurance carrier would pay for services until post transport when the insurance carrier issues its decision.After the claim for air ambulance services was submitted to the insurance carrier, the insurance carrier elected to review the medical records from the sending facilityAn investigation was made by the insurance carrier and it was discovered, and then relayed to MLM, that the patient refused services offered at the sending facility and ultimately signed out of the hospital voluntarilyBecause the patient was in need of a coronary angiography which could allegedly be provided at the sending facility, and the patient refused such services, the insurance company denied the claim for transport as not medically necessaryThe basis for denial is out of the hands of MLMAs a result of the actions, the benefits for air ambulance services available to the consumer under their plan was apparently waived by the consumer’s decision to refuse treatmentThese facts were not known to MLM at the time of service.Under the terms of the MLM agreement with the consumer, the consumer is ultimately responsible for the cost of the services renderedHere, there is no question whether or not services were renderedThe issue here is why the air ambulance service, which is a benefit in the consumer’s plan, was not coveredThe consumer has corroborated the information provided to MLM by the insurance carrier and confirmed that the refusal to accept services at the sending facility resulted in a denial of coverageA letter was sent to the consumer by their insurance carrier advising of the sameMLM provided a letter to the consumer requesting payment for servicesThe consumer refused to pay for the servicesMLM was forced to absorb the debt as a result of non-paymentThe complaint by the consumer is not the result of any misinformation at the hands of MLM and should be withdrawnFurther, the request for resolution was to not pay the debt to MLM which the consumer did not payTherefore, the complaint can be, at a minimum, marked as resolved.I hope this resolves the consumer complaint dated September 2, If you need anything further, please do not hesitate to call me at [redacted] .Sincerely, [redacted] , Esq

Thank you for the opportunity to respond to Mr [redacted] complaintMedical Logistics Management (“MLM”) will not speak to the subjects of the complaint not associated with the air ambulance transportSpecifically, MLM has no opinion as it relates to issues with Carnival, services offered at the hospital, calls made to the hospital, alleged information provided by the hospital during telephone calls, or decisions made by the consumer of which MLM was not a party.As it relates to the service rendered, MLM provided an air ambulance transport for Mrs [redacted] as indicated by the consumerAs a service to its patients, MLM submits all insurance documents for the consumer and on the consumer’s behalf advocates for coverageIn this case, MLM did not require the consumer to make any payments in advance of the services being rendered, but instead, secured terms through contractsUnder the terms of the insurance plan with the consumer, the insurance carrier determines whether or not it will pay for servicesIn this instance the insurance carrier did a medical necessity analysisThe consumer is correct that the consumer does have out-of-country air ambulance servicesThis is the same information MLM received in advance of transportHowever, a decision to pay for services is not done in advance of the transport unless a pre-authorization is requested and such request was not done on emergency Services such as the service provided to the consumerAccordingly, the consumer would not have been apprised of whether the insurance carrier would pay for services until post transport when the insurance carrier issues its decisionAfter the claim for air ambulance services was submitted to the insurance carrier, the insurance carrier elected to review the medical records from the sending facilityAn investigation was made by the insurance carrier and it was discovered, and then relayed to MLM, that the patient refused services offered at the sending facility and ultimately signed out of the hospital voluntarilyBecause the patient was in need of a coronary angiography which could allegedly be provided at the sending facility, and the patient refused such services, the insurance company denied the claim for transport as not medically necessaryThe basis for denial is out of the hands of MLMAs a result of the actions, the benefits for air ambulance services available to the consumer under their plan was apparently waived by the consumer’s decision to refuse treatmentThese facts were not known to MLM at the time of serviceUnder the terms of the MLM agreement with the consumer, the consumer is ultimately responsible for the cost of the services renderedHere, there is no question whether or not services were renderedThe issue here is why the air ambulance service, which is a benefit in the consumer’s plan, was not coveredThe consumer has corroborated the information provided to MLM by the insurance carrier and confirmed that the refusal to accept services at the sending facility resulted in a denial of coverageA letter was sent to the consumer by their insurance carrier advising of the sameMLM provided a letter to the consumer requesting payment for servicesThe consumer refused to pay for the servicesMLM was forced to absorb the debt as a result of non-paymentThe complaint by the consumer is not the result of any misinformation at the hands of MLM and should be withdrawnFurther, the request for resolution was to not pay the debt to MLM which the consumer did not payTherefore, the complaint can be, at a minimum, marked as resolvedI hope this resolves the consumer complaint dated September 2, If you need anything further, please do not hesitate to call me at [redacted] Sincerely, [redacted] , Esq

Thank you for the opportunity to respond to Mr. [redacted] complaint. Medical Logistics Management (“MLM”) will not speak to the subjects of the complaint not associated with the air ambulance transport. Specifically, MLM has no opinion as it relates to issues with Carnival, services offered at...

the hospital, calls made to the hospital, alleged false information provided by the hospital during telephone calls, or decisions made by the consumer of which MLM was not a party.As it relates to the service rendered, MLM provided an air ambulance transport for Mrs. [redacted] as indicated by the consumer. As a service to its patients, MLM submits all insurance documents for the consumer and on the consumer’s behalf advocates for coverage. In this case, MLM did not require the consumer to make any payments in advance of the services being rendered, but instead, secured terms through contracts. Under the terms of the insurance plan with the consumer, the insurance carrier determines whether or not it will pay for services. In this instance the insurance carrier did a medical necessity analysis. The consumer is correct that the consumer does have out-of-country air ambulance services. This is the same information MLM received in advance of transport. However, a decision to pay for services is not done in advance of the transport unless a pre-authorization is requested and such request was not done on emergency Services such as the service provided to the consumer. Accordingly, the consumer would not have been apprised of whether the insurance carrier would pay for services until post transport when the insurance carrier issues its decision.After the claim for air ambulance services was submitted to the insurance carrier, the insurance carrier elected to review the medical records from the sending facility. An investigation was made by the insurance carrier and it was discovered, and then relayed to MLM, that the patient refused services offered at the sending facility and ultimately signed out of the hospital voluntarily. Because the patient was in need of a coronary angiography which could allegedly be provided at the sending facility, and the patient refused such services, the insurance company denied the claim for transport as not medically necessary. The basis for denial is out of the hands of MLM. As a result of the actions, the benefits for air ambulance services available to the consumer under their plan was apparently waived by the consumer’s decision to refuse treatment. These facts were not known to MLM at the time of service.Under the terms of the MLM agreement with the consumer, the consumer is ultimately responsible for the cost of the services rendered. Here, there is no question whether or not services were rendered. The issue here is why the air ambulance service, which is a benefit in the consumer’s plan, was not covered. The consumer has corroborated the information provided to MLM by the insurance carrier and confirmed that the refusal to accept services at the sending facility resulted in a denial of coverage. A letter was sent to the consumer by their insurance carrier advising of the same. MLM provided a letter to the consumer requesting payment for services. The consumer refused to pay for the services. MLM was forced to absorb the debt as a result of non-payment. The complaint by the consumer is not the result of any misinformation at the hands of MLM and should be withdrawn. Further, the request for resolution was to not pay the debt to MLM which the consumer did not pay. Therefore, the complaint can be, at a minimum, marked as resolved.I hope this resolves the consumer complaint dated September 2, 2015. If you need anything further, please do not hesitate to call me at [redacted].Sincerely,[redacted], Esq.

Thank you for the opportunity to respond to Mr. [redacted] complaint. Medical Logistics Management (“MLM”) will not speak to the subjects of the complaint not associated with the air ambulance transport. Specifically, MLM has no opinion as it relates to issues with Carnival, services offered...

at the hospital, calls made to the hospital, alleged false information provided by the hospital during telephone calls, or decisions made by the consumer of which MLM was not a party.As it relates to the service rendered, MLM provided an air ambulance transport for Mrs. [redacted] as indicated by the consumer. As a service to its patients, MLM submits all insurance documents for the consumer and on the consumer’s behalf advocates for coverage. In this case, MLM did not require the consumer to make any payments in advance of the services being rendered, but instead, secured terms through contracts. Under the terms of the insurance plan with the consumer, the insurance carrier determines whether or not it will pay for services. In this instance the insurance carrier did a medical necessity analysis. The consumer is correct that the consumer does have out-of-country air ambulance services. This is the same information MLM received in advance of transport. However, a decision to pay for services is not done in advance of the transport unless a pre-authorization is requested and such request was not done on emergency Services such as the service provided to the consumer. Accordingly, the consumer would not have been apprised of whether the insurance carrier would pay for services until post transport when the insurance carrier issues its decision.
After the claim for air ambulance services was submitted to the insurance carrier, the insurance carrier elected to review the medical records from the sending facility. An investigation was made by the insurance carrier and it was discovered, and then relayed to MLM, that the patient refused services offered at the sending facility and ultimately signed out of the hospital voluntarily. Because the patient was in need of a coronary angiography which could allegedly be provided at the sending facility, and the patient refused such services, the insurance company denied the claim for transport as not medically necessary. The basis for denial is out of the hands of MLM. As a result of the actions, the benefits for air ambulance services available to the consumer under their plan was apparently waived by the consumer’s decision to refuse treatment. These facts were not known to MLM at the time of service.
Under the terms of the MLM agreement with the consumer, the consumer is ultimately responsible for the cost of the services rendered. Here, there is no question whether or not services were rendered. The issue here is why the air ambulance service, which is a benefit in the consumer’s plan, was not covered. The consumer has corroborated the information provided to MLM by the insurance carrier and confirmed that the refusal to accept services at the sending facility resulted in a denial of coverage. A letter was sent to the consumer by their insurance carrier advising of the same. MLM provided a letter to the consumer requesting payment for services. The consumer refused to pay for the services. MLM was forced to absorb the debt as a result of non-payment. The complaint by the consumer is not the result of any misinformation at the hands of MLM and should be withdrawn. Further, the request for resolution was to not pay the debt to MLM which the consumer did not pay. Therefore, the complaint can be, at a minimum, marked as resolved.
I hope this resolves the consumer complaint dated September 2, 2015. If you need anything further, please do not hesitate to call me at [redacted].
Sincerely,
[redacted], Esq.