Rocky Mountain Holdings, LLC

Re: complaint ID: [redacted] Dear [redacted] ,Our office is in receipt of correspondence from your office dated December 2, regarding a complaint submitted by [redacted] , a former patient of ours who received air ambulance services on September 15, We are pleased to report that *** [redacted] 's insurer, BCBS GA remitted payment in full for our services on December 8, A zero balance statement of account was mailed to [redacted] on December 15,for his records.We are proud to have provided emergency air ambulance services to [redacted] Feel free to contact our office again should we be of any further assistance at [redacted] .Thank you, [redacted]

The business stated they will have their complete response by the end of the business dayI will wait to see what they have to say Complaint: [redacted] I am rejecting this response because: Sincerely, [redacted]

Initial Business Response / [redacted] (1000, 12, 2015/07/14) */ From: [redacted] , [redacted] (mailto: [redacted] @airmethods.com) Sent: Tuesday, July 14, XXXX X:XX PM To: [redacted] Subject: CID# [redacted] - [redacted] Ms [redacted] Thank you for your e-mail last weekAs follto my voice-mail message, I believe there must be some confusion or misplacement of our responseI show we submitted our response via fax on June 26, I've attached a clean copy of our response to include fax confirmations for our faxed response to both your office and the Kentucky Revdex.com, as Mr [redacted] also filed a completed there Feel free to contact me again should you need anything additional [redacted] M [redacted] Senior Paralegal [redacted] San Bernardino, CA XXXXX O: (XXX) XXX-XXXX F (XXX) XXX-XXXX [redacted] @airmethods.com airmethods.com facebook Documents scanned June 26, Via Fax: (303) [redacted] Revdex.com DenverBoulder [redacted] E [redacted] Denver, CO XXXXX Re: Case # 75256078: [redacted] Dear Ms [redacted] This letter is submitted on behalf of Rocky Mountain Holdings, LLC, a wholly-owned subsidiary of Air Methods Corporation (together, “Air Methods†), in response to your letter dated June 15, regarding a complaint filed by Mr [redacted] (the “Complaint†), the father of a former patient of ours, [redacted] , who received emergency medical transport services from Air Methods on August 6, (the “Patient†) Background To provide you with some background on the services provided to this Patient and her account with Air Methods, the Patient received inter-facility transport services by Air Methods on August 6, from [redacted] Hospital in Owensboro, Kentucky to [redacted] Hospital in Louisville, KentuckyAir Methods provided the transport of the Patient at the request of [redacted] HospitalThe billed charges for the emergency services provided by Air Methods for this particular Patient transport are in the amount of $47,088.16, which include a $25,base liftoff fee and total mileage fee of $21,for this seventy nine (79) mile flightThe Patient’s insurer [redacted] issued a payment in the amount of $14,on December 30, leaving a balance of $32,as patient responsibility Medical Necessity of the Emergency Services As with all inter-facility transpons, Air Methods is not the party determining whether ground or air transport is the most appropriate means of transport for the patientRather, it is the responsibility of the treating medical physicianIn this case, it was Dr [redacted] from the trauma bay at [redacted] Hospital who determined rapid air medical transport was medically necessary based on the a skull fracture the Patient sustained from an ATV injuryDr [redacted] made this determination based on the following criteria: (1) transport is time critical in order to minimize morbidity/mortality; (2) The patient’s condition met established criteria for transport based on published standards for appropriate utilization of air transport from EMS, [redacted] S [redacted] CO XXXXX/WWW.AIRMETHODS.COM cardiac, trauma, pediatric, or neonatal communities; (3) during transport the Patient’s condition required critical care life support and monitoring by an Advanced Life Support medical staff including a Registered Nurse; and (4) the receiving facility provided specialized care, treatment, and diagnosis not available at the referring facility, specifically Pediatric Surgery Unit At the time of transport, the nurses and paramedics focus solely on the emergency medical care they are providing to the patient and not whether or how a patient can pay for the air medical transportIndeed, we are prohibited from screening for insurance eligibility prior to a patient transport, and we transport all patients regardless of whether they are insured or the amount of their insurance benefit for our servicesFor your convenience, we have enclosed here the Physician Certification Statement signed by Dr [redacted] from [redacted] Hospital attesting to the basis he used to determine that emergency air ambulance services were medically necessary and appropriate at the time of transport as well as the Authorization and Consent signed by Mr [redacted] at the time of service Additionally, Air Methods takes very seriously the allegations of unprofessional behavior by the medical crew asserted in the ComplaintAir Methods contracts with [redacted] Hospital to provide the medical crew for this air medical programWe have worked with them to complete an investigation surrounding this concernThe investigation revealed that appropriate healthcare treatment was provided to the Patient and [redacted] Hospital explained to Mr [redacted] the reason that treatment for his daughter was necessaryFurthermore, contrary to the Patient’s allegation regarding response times, our records do not reflect an inadequate delay in transporting the PatientPursuant to the orders of the attending medical physicians, Air Methods was required to first pick up the pediatric specialty medical crew from [redacted] Hospital (the receiving facility) prior to its route to the [redacted] Hospital (sending facility)Once Air Methods arrived at the sending hospital, the pediatric medical crew worked as quickly as possible to prepare the Patient for transport and finalize emergency services, which can take some time The Reasonableness of Air Methods' Charges Air Methods respectfully disagrees with the Patient’s claim in the Complaint that our charges are excessiveFirst, Air Methods’ charges are reasonable and customary, as necessitated by the high cost of providing safe and effective emergency air transport around-the-clock and often in rural areas, such as this area of KentuckyAir medical emergency transport is highly specialized and distinct sendee that is necessarily costly due to a number of factors, including the maintenance of expensive aircraft and equipment as well as the employment of sophisticated aviation and clinical personnel to maintain 24-hour readinessImportantly, Air Methods has no ability to determine in advance whether its patients will be able to pay for its services—we transport all patients without regard to ability to pay, and we never ask prior to the transport whether the patient has insurance coverage or in what amountTo provide this life-saving emergency service, especially in rural areas of Kentucky where communities and patients do not have immediate access to adequate trauma care, we must ensure that our charges are sufficient to remain viable and continue providing such services Air Methods’ charges are consistent with the charges of other similar competitors in the Kentucky area, and the amount reimbursed by [redacted] falls far below the usual and customary charge for such air ambulance servicesUnfortunately for this Patient’s family, [redacted] has done them a great disservice by underpaying their claim and leaving them with the balance Air Methods' Commitment to Patients with Financial Hardship Air Methods takes very seriously its commitment to helping those patients with financial hardship, and we have a long-established charity care process in place to resolve such patient accountsAir Methods discussed with the Patient a possible reduction of the balance in accordance with its policies and procedures by outlining various reductions on the total balance based on the Patient’s individual financial circumstances to include prompt pay resolutions, payment plan options and the completion of our Special Consideration ApplicationAir Methods mailed the Patient this charity application on May 19, but a completed copy has not yet been received by our office to date Air Methods would be willing to work through your office or the Patient directly to resolve payment due on this accountAdditionally, Air Methods would be glad to consider an application for charity care on behalf of the Patient should the Patient choose to submit it, and at that time we can determine whether any further discount based on their individual circumstances is warranted Please let us know if you need additional information regarding this matter Respectfully submitted, [redacted] Associate General Counsel Air Methods Corporation

Thank you for your patience while I was collecting information and preparing our response Please let me know if you need anything further

[redacted] : Attached please find our response to the Revdex.com complaint filed by [redacted] *** Thank you [redacted] [redacted] [redacted] * [redacted]

Ref complaint ID: [redacted] Dear [redacted] ,Our office is in receipt of correspondence from your office dated October 16, involving a complaint received in your office from a [redacted] [redacted] indicates he received a bill from our company for services he did not receiveIn a complete review of our system, we do not find any record of an account or open balance for [redacted] We are happy to review any documentation [redacted] received and investigate this further.Feel free to contact our office again at [redacted] , should you have questions.Thank you, [redacted]

Complaint: [redacted] I am rejecting this response because: Air Methods recently sent me another document with some unfair language in it I will have to see how it unfolds BTW, Air Methods arrived hours later than the time they promisedWe could have easily transport the baby using a car ambulance Also, the insurance info was added on the day that baby was transported and I called Air Methods in approximately month later to provide the insurance infoOther hospitals provided the insurance info between those time didn't have any trouble getting money from the insurance company I do not quite understand why only Air Methods had trouble Until Air Methods receive money from BCBS and stop sending me the bills, I would like to have this complain open and not resolved Sincerely, [redacted] ***

Please see attached document for response to complaint

Complaint: [redacted] I am rejecting this response because:They are stating they need more information and can not locate the fileMy daughters name is [redacted] ***, her date of birth is [redacted] and the date of service is [redacted] They reciently submitted the account to collects, that's why I initiated the complaint Sincerely, [redacted]

Complaint: [redacted] I am rejecting this response because:All they are stating in this letter is what I have been arguing with them about for monthsI agree dedicated to arrange a payment of the $from capital blue cross but they refused to make payment arrangements for meThey also didn't initiate this "debt" in a timely fashion since AmeriHealth Caritas had told me they wouldn't pay it anymore due to the fact it was over the amount of time allowable to submit a claim, even when they started contacting me in June of The AmeriHealth representative we spoke with, on the three-way call, stated she could not do anything since they won't sunmitigated the claim without the initial $from capital blue crossAs I stated before it's too late anyway, and it has been since 12/The explained to me they only allow claim to be submitted within one yearThis happened 12/and they reached out to be on 6/in regards to the capital blue cross paymentThe way this was handled was very late and unprofessionalI tried my hardest to work something out but Ithe was already too lateThey also tacked on almost $in interest to the account that was sent to collections Sincerely, [redacted]

I am completing my due diligence and working on the response and will have finalized by the end of business today

Ref complaint ID ***Dear *** ***,Our office is in receipt of correspondence from your office dated October 14,regarding a complaint submitted by *** *** ** ***, a former patient of ours who received air tranport services on September 21,2014.We are pleased to inform you
that *** *** insurer, Capital Blue Cross reprocessed *** *** claim and issued additional payment for the full balance of *** *** billOur office secured this payment on January 8,and will be mailing MrFrancisco a zero balance statement of account for his records.Feel free to contact our office at ***, should you have questions or require anything additional.Thank you,*** ** ***

*** ***, Thank you very much for your reponse. I am sorry you did not receive the full response we submitted to the Revdex.com officePerhaps they can assist in ensuring you are provided with a complete copy but we are also happy to mail it to you to the address on file.We stand by our initial response with respect to how your qualified attending physian determined air ambulance transportation services were medically necessaryWe also standy by our charges and feel they are reasonable in comparison to other similarly situated air ambulance providers in your community.We hope you find this information to be sufficient. We are proud to have provided air medical transportation services to you.Respectfully,*** ** ***

Complaint: ***The company, Air Methods, still refuses to provide a sufficient answer to the complaint. The charges are excessive. Stating they "stand behind" the costs as this is what is comparable in the industry is NOT a sufficient answer. I have requested a detailed breakdown of the costs. How is the base price calculated? A charge of ~$29K is extremely excessive as a base figure for service. The county ambulance service charged ~$1K as their base price. And I am to accept a charge times the base of an ambulance service because it was air transport? The industry as a whole is unregulated in pricing for their services. Continued refusal of the company to disclose pricing practices creates an environment where such outrageous charges can exist.As a consumer who, based on various loopholes in our healthcare policy, received a service that someone else determined I needed while I was lucid and capable of determining my own welfare. I reject the response from the company as it continues to fail to answer the fundamental pricing practices.I am requesting detailed disclosure of a service I was FORCED to pay through my insurance company. A majority of the funds provided to settle the charge should be returned to the insurance company as excessive charges.
Sincerely,
*** ***

Need more information...unable to locate patient account. Need daughters name, date of birth, date of service and/or Run # from most recent bill.Cannot locate the account. Please provide more information so we can respond. Thank you

Complaint: ***
I am rejecting this response because: This company still does not answer the complaint. The current response deflects the complaint by stating they've answered it previously, which is not true. Secondly, the company refers me to SEC since they are a "publicly traded company". Air Methods' business model is not transparent to the consumer. They fail to provide an answer to a simple request that was to provide detailed pricing information and explain how they derived at a charge that is fair and comparative to ambulance services times greater than normal. And let me be very clear I am referring to a traditional ambulance service at a base charge of $1K to an air transportation at a base charge of $29K. Unless they provide a direct response that justifies these charges versus vague answers such as "We stand behind our previous response." Then they are not providing a satisfactory response to the complaint
Sincerely,
*** ***

Complaint: ***
I am rejecting this response because: the letter was only partially received.Again, the company fails to address the issues at hand. The flight cost, while justifiable to the company, is an excessive amount. A majority of this cost should be returned to the insurer. The company to date fails to provide a suitable answer the their pricing practices. As an individual with rights I should have consented to these charges prior to any service rendered. The other issue, which is minor, is the consistent reference to me as their patient. A patient (n) is a person receiving or registered to receive medical treatment. The company did not provide "medical treatment". They provided an ambulance service that transported me to a medical facility to provide such treatment. Although this semantic debate may not be resolved it does illustrate a practice by the company to which it approaches the excessive charges for a mile flight that medical insurance will pay. As I have researched this industry I have been alarmed by the practices air ambulance services. I am not the first individual to bring attention to the high cost of medical air transportation. My insurance company, *** *** *** ***, has written in their policy that if the transportation was required for a medical emergency that was life threatening then the cost of the service will be paid minus a $deductible. The point to this complaint is the company does NOT justify these excessive charges. As consumers of health we all should be alarmed at such practices in our medical system because we all pay the cost in the end (i.erising health care costs).The company received payment from my insurer, but this does not make it right. There are several issues at hand that need resolution. Regardless if a medical professional called for transportation the individual receiving such service should be informed of the costs if lucid. Consent should be sought. Public disclosure of true costs should be provided when asked. The cost breakdown should be provided to the insurance company and consumer. Therefore, I fully reject the company's recent response. First, a copy of the full letter was not provided. Second, the cost breakdown provided is to broad. It cost over $26K for what? The ~$per mile makes sense. I want this information to release to the public and use in my speeches. If the company provides such services then transparency to the consumer should be paramount
Sincerely,
*** ***

Ref complaint ID ***Dear *** ***, Our office is in receipt of correspondence from your office dated October 13, regarding a complaint submitted by *** *** ***, the daughter of *** *** ***, a former patient of ours who received air ambulane services on March 30, 2015.Our
records indicate that an itemized invoice was provided to *** *** on October 14, and the account was closed/paid in full on November 5, Feel free to contact our office again at ***, should you have any further questions.Thank you,*** ***

Dear *** ***,Thank you for your recent communicationWe feel we have appropriately addressed your concerns related to both medical necessity for your transport and reasonableness of our chargesWith respect to your request for additional information regarding our costs, we are a publically traded company and you can find such information in our SEC filings availble online at www.sec.gov.Respectfully,*** ***

The business stated they will have their complete response by the end of the business day. I will wait to see what they have to say. 
Complaint: [redacted]
I am rejecting this response because:
Sincerely,
[redacted]