Bike Accident - Helicopter

[featuretile]

About 4 weeks ago I had an accident on my bike. I really don't know what happened. One minute I was riding along about 15mph on a road that I ride frequently - not doing anything particularly risky, and the next thing I remember is being in an ambulance. My husband, who was in front (so did not see anything) says that there was a loose piece of asphalt in the bike lane which I guess I did not see. I was trying to catch him to draft as there was quite a headwind. The bike lane gets a little narrow there and there is lots of eucalyptus debris, also mottled light.

I hit my head and the helmet cracked and I had a slight concussion, facial road rash and a broken finger. Because I had been briefly unconscious the EMT said I needed to go to a hospital with a trauma center. I did not know that we don''t have one in this county. I also did not know that my medical insurance only covers $1000 of transport. The bill for this helicopter flight is $23,000. Basically, they told my husband that if I did not get to a trauma center in an hour, I could die.

So, I want everyone to know that they should check their county for trauma center availability and check their insurance coverage. It seems there are some helicopter companies where you can get insurance or membership - wish we had known about that. We will try to negotiate it down - but really this is ridiculous.

Anyway, my face is healing nicely. And my finger is ready for physical therapy. The one thing they did not tell me in the hospital is just how fatigued I would be for weeks after the accident. Apparently, that is normal after a head trauma. I am starting to get my energy back.

I almost get sick watching these people bike by me without a helmet. I'll be fine, but if I did not have a helmet on, I might not be.

Just an aside - my carbon bike (Ruby) was fine. I did have it checked out by a professional. All she needed is new handlebar tape. I guess I took the impact rather than the bike.

I really don't understand how I fell. All the damage was to my right side, yet my husband said he found me on my left side with the bike on top of me. The only damage to the bike was a few scratches and the front part of the shifters on both sides is very scraped (like I went forward on the handlebars). So, how did I fall?

[Owlie]

About 4 weeks ago I had an accident on my bike. I really don't know what happened. One minute I was riding along about 15mph on a road that I ride frequently - not doing anything particularly risky, and the next thing I remember is being in an ambulance. My husband, who was in front (so did not see anything) says that there was a loose piece of asphalt in the bike lane which I guess I did not see. I was trying to catch him to draft as there was quite a headwind. The bike lane gets a little narrow there and there is lots of eucalyptus debris, also mottled light.

I hit my head and the helmet cracked and I had a slight concussion, facial road rash and a broken finger. Because I had been briefly unconscious the EMT said I needed to go to a hospital with a trauma center. I did not know that we don''t have one in this county. I also did not know that my medical insurance only covers $1000 of transport. The bill for this helicopter flight is $23,000. Basically, they told my husband that if I did not get to a trauma center in an hour, I could die.

So, I want everyone to know that they should check their county for trauma center availability and check their insurance coverage. It seems there are some helicopter companies where you can get insurance or membership - wish we had known about that. We will try to negotiate it down - but really this is ridiculous.

Anyway, my face is healing nicely. And my finger is ready for physical therapy. The one thing they did not tell me in the hospital is just how fatigued I would be for weeks after the accident. Apparently, that is normal after a head trauma. I am starting to get my energy back.

I almost get sick watching these people bike by me without a helmet. I'll be fine, but if I did not have a helmet on, I might not be.

Just an aside - my carbon bike (Ruby) was fine. I did have it checked out by a professional. All she needed is new handlebar tape. I guess I took the impact rather than the bike.

I really don't understand how I fell. All the damage was to my right side, yet my husband said he found me on my left side with the bike on top of me. The only damage to the bike was a few scratches and the front part of the shifters on both sides is very scraped (like I went forward on the handlebars). So, how did I fall?

Ouch. Gentle hugs. I'm glad you're okay, at least mostly. And I'm glad your bike is okay too. ;)
My guess is you hit the chunk of asphalt, endo'd, and rolled.

I've got no advice on the insurance, but it sounds familiar. When DBF crashed (going 30 miles an hour), his parents' insurance (since he was in 8th or 9th grade at the time) initially refused to cover helicopter flight to the hospital. It took a statement from the EMT/paramedic who had made the call (uh, guys? Potential head+ neck injury...) to get them to cover it. They also initially refused to cover the various procedures to fix his face, because they saw that the doc who had performed them was a plastic surgeon. :rolleyes:

[Chile Pepper]

Yikes! What a scary experience! So glad you are feeling better. Hope you heal quickly.

[murielalex]

Sorry that you now have the added stress of financial garbage to your healing process, but I'm glad you experienced nothing worse.

[Melalvai]

After my daughter's wreck, we signed up for AirEvac. They had the helicopter on standby for her, but didn't end up using it.

[OakLeaf]

Wow. ((((((featuretile)))))) So sorry you're having to go through this - glad your injuries weren't worse, wish our health care system was better. :(

[malkin]

Because I had been briefly unconscious the EMT said I needed to go to a hospital with a trauma center. I did not know that we don''t have one in this county. ... Basically, they told my husband that if I did not get to a trauma center in an hour, I could die.

Say this in every conversation with your insurance. Remind them often.




I really don't understand how I fell. All the damage was to my right side, yet my husband said he found me on my left side with the bike on top of me. The only damage to the bike was a few scratches and the front part of the shifters on both sides is very scraped (like I went forward on the handlebars). So, how did I fall?

Maybe you hit hard on your right and then rolled over.
Both of my crashes I have wondered about this too.

Good healing to you.

[bluebug32]

Wow, I'm just glad you're okay. Good luck with the insurance company. What a pain, but at least you walked away without any major injuries.

[tzvia]

Oh wow. That sucks at every level. Glad you are healing up well, and that is the most important part.

As for your crash, it sounds like that loose asphalt and/or the eucalyptus debris was a factor, you may have lost traction in the debris and/or hit the loose asphalt and lost control. I hate to say it too, as others have, but maybe a lawyer? The city is responsible for the bike lane as it is for the street (unless you were on private property). I hate to sound like 'Oh joy, time for a slip and fall lawyer' but there may be something here other than you just la-la'd out and fell over.

[laura*]

About 4 weeks ago I had an accident on my bike. I really don't know what happened.

Oh my! I think I read a brief news article about your crash on the local paper's website. The article didn't say much - just that a rider had been helicopter evac'ed after a no-cars-involved crash.

Hope your recovery goes fine!

[Catrin]

Oh my! I am so glad you were not injured worse than you were and so sorry that you have to deal with the insurance issues - I hope you are able to resolve this soon so that stress can be removed.

[hebe]

I'm glad you're ok and hope that the rest of your recovery is smooth and swift.

[indysteel]

Oh my gosh. How terrifying. I'm glad you're mostly okay and I hope your rehab goes well. Hopefully, the provider (not sure if the helicopter is a service of the hospital or seperate entity) will be willing to negotiate with you. Thanks for bringing the issue to our attention. I can't say that I've ever thought about what would happen if I needed a helicopter, be it from a bike or car accident. But now that I live outside the Indianapolis metro area, that is something to think about.

[shootingstar]

Glad you're healing featurile. That is scary.

And that helicoper airlift bill-- shocking. Let us know of outcome.

[Maye]

First of all I'm glad that you are healing fine and sharing your experience with us here, TODAY. A big hug from me!!

I'll echo what others said here, you should get a lawyer with accident/injury experience to help you with this and to negotiate the bill with the helicopter company. Hopefully he won't charge you more than what you owe to the helicopter company :eek:. I do really hate the "get a lawyer" route but, what can you do? Oh, also thanks for the helicopter service heads up. I live in Orange County FL and I will search for this service and how it works here.

This is funny (not funny like ha ha) but yesterday when we were driving back home through the Florida I-4 route, I saw hundreds of billboards of lawyers offering the: Did you have an Accident? Are you Injured? service and I was so tired of the billboards that I told my husband that if I see one more I was going to throw up. And look at me today, advising to you to look for one. Ironic...

[withm]

http://www.sfhelicoptertours.com/charters/

This outfit offers helicopter charters for up to 6 people for $1,975./hr I don't know how old that website is, but just offer it for some perspective.

Clearly some negotiation is in order here.

[wackyjacky1]

As for your crash, it sounds like that loose asphalt and/or the eucalyptus debris was a factor, you may have lost traction in the debris and/or hit the loose asphalt and lost control. I hate to say it too, as others have, but maybe a lawyer? The city is responsible for the bike lane as it is for the street (unless you were on private property). I hate to sound like 'Oh joy, time for a slip and fall lawyer' but there may be something here other than you just la-la'd out and fell over.
100% agree with this.

So glad you're feeling better.

[Melalvai]

I don't hate to say it: "Get a lawyer!"

In retrospect I wish we'd gotten a lawyer before doing anything else, before even talking to insurance. I've heard quite a few stories since then, and I would say no matter what, get a lawyer.

Of course, my opinion of lawyers has changed since my sister became a lawyer and my brother started law school (he graduates in a month!)

[featuretile]

Thanks for all the kind thoughts. Not sure about suing the city, but I did ask my brother who is a lawyer (but not that kind and he lives in Texas) what to do. I am also not sure if I can get the insurance company to do anything. I just got an invoice from them and all the medical costs seem reasonable (minus the big deductible) but the helicopter is not covered. I don't know if there is any recourse to get them to negotiate with the helicopter company since I was told it was medically necessary. I did get advice not to pay anything until some negotiation happens. We still have not gotten the final bill for this whole thing.

I will let you all know how it works out - whenever that happens. I'm thinking this will drag out. I did want everyone to know about the helicopter costs so that if you are in an area like mine, you could see if there is some sort of insurance. I need to check out that AirEvac. I did look at one site but it sounded more like getting you back from some foreign country rather than taking you to a nearby hospital.

[PamNY]

Glad you are healing well. Good luck with whatever negotiations/legal actions you end up pursuing.

[jessmarimba]

Good luck, and I'm glad your injuries weren't worse!

I had some initial trouble with my insurance company after a wreck a couple years ago (though I turned down the helicopter, not knowing how bad my injuries were) and for me, the phrase "life-threatening injuries" was enough to overturn every one of their denials. Granted, my problem was out-of-network doctors working the trauma center, but there's sometimes a clause in the fine print somewhere that forces them to cover transport coded with a serious threat to life. (Along those lines, if you can check your claims online or have the paperwork in hand already, you can double-check the code numbers for the transport - sometimes the billing people at the hospital will miscode something that will cause a denial when it shouldn't be).

[featuretile]

So, I contacted my insurance company today about the $23,000 helicopter bill. They said that the helicopter company had not filed a pre-certification so they denied their claim. They said I am not responsible for the bill. After I meet my $5000 deductible (I've apparently already met that), they will pay the rest. But the helicopter company would have to file the correct paperwork and resubmit. If they try to bill me directly, I should send it to them. This is different than what they told my husband the first time he called (that there was a $1000 limit on transport). I think the medically necessary part must trump that. Anyway, I AM RELIEVED! We haven't gotten all the bills yet. Don't know how long that will take and if there will be any more surprises. But $5000 sounds a lot better than $5000 plus $23,000.

[goldfinch]

Good to hear and this makes a lot more sense.

[ny biker]

Well that is good news.

Though I don't understand how a helicopter company (or any emergency transport company) is supposed to pre-certify with the insurance company in a life-threatening situation. But anyway.

[tulip]

Glad you are okay. I had a very similar accident about 10 years ago. I was riding behind my riding buddy and our wheels crossed because I got too close to his rear wheel. I completely missed my 'copter ride, though. I was out.

I never received a bill for the helicopter ride, nor for the hospital. The hospital apparently had some management issues and shortly thereafter was taken into receivership, so I guess that's the reason.

[jobob]

Heh, I still have the bill for the helicopter ambulance ride from my crash, lurking someplace in my files.

It had, in very large letters at the top, THIS IS NOT A BILL, followed by something to the effect that my insurance company had been billed and that I'd hear back from them presently.

Didn't keep my stomach from dropping to the floor when I saw the amount, which was, coincidentally, about $23,000. :eek:

I ended up having to cough up a few thousand dollars, but, I consoled myself with the fact that it wasn't 23 grand. :rolleyes:

[jobob]

Maybe this is why the do it, so we pay the several thousand willingly.

I'm such a cynic.

LOL, that was my impression too. ;)

I can't complain too much though. All told, the costs incurred by my crash amounted to something like $150,000 of which I had to shell out "only" (heh) about $8,000.

But, it could have been worse, financially and otherwise -- I recovered completely. :)

Best wishes for your recovery, featuretile. The fatigue does go away. You didn't mention any memory issues, but memory lapses are also pretty common with head trauma. Those go away with time as well ... I think. :D

[featuretile]

Where do they come up with these numbers like $23,000? Yesterday I got a bill for $4000 for the ambulance that took me to the helicopter. I sent it to the insurance company. I agree that after seeing these crazy amounts, we willingly pay several thousand dollars. And never want to get in an ambulance or a helicopter again.

Health care costs are a nightmare. If I did not have any insurance (because of pre-existing conditions or cost or age - it ws really hard to get anything when my DH 'retired'), then the helicopter would want $23,000 and the ambulance would want $4000. And that does not include doctors and hospital costs. These bills would go to someone who doesn't have enough money to get health insurance (unemployed?). And of course, the insurance company gets discount rates where we mere mortals do not.

I did not have any memory issues. I was just a little slow the first few weeks and knew I should not drive a car because I questioned my reaction time. Two more weeks before I can try riding a bike again!

[jobob]

It should be no surprise that a majority of personal bankruptcies are on account of medical bills.

[rivergal]

Hope 7 days out that you're feeling better and mending well. Thanks so much for sharing your story. I checked my insurance and although I would have to pay 20% in network or 5K out of network, that is so much better than no coverage at all.

I guess I will gripe a bit less this month when I pay my bill.

[Melalvai]

And of course, the insurance company gets discount rates where we mere mortals do not.
A friend was unemployed for a bit while his wife was in school and had that issue where self-pay was ridiculously more expensive than the insurance negotiated rate.

[Melalvai]

Here's a study that just came out that severe trauma victims survive more if they are transported by helicopter (http://www.sciencedaily.com/releases/2012/04/120417102048.htm?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+sciencedaily%2Fscience_society%2Fpublic_health+%28ScienceDaily%3A+Science+%26+Society+News+--+Public+Health%29).

[Deborajen]

So, how long was the helicopter ride (distance)? I work at a doctors' office and just this week we had a patient send us all of his medical bills for his hospitalization to show his expenses to negotiate a discount on our doctor's bill. One of his bills was for helicopter transport from his local hospital to one of our city's hospitals. It was about 50 miles and the bill was $14,000.00. Just wondered how that compares with the distance you were transported?

You said that at first insurance denied the bill saying they only covered local transport and now they're saying the transport company didn't precertify so the bill is denied and you don't have to pay. A couple of suggestions here:

1. Make sure the transport company contracts with your insurance, ie., they're on the preferred provider list. If they aren't, then insurance company can't diictate what is billed or written off and if they bill you, you ARE responsible. If they are on the preferred list, and insurance requires them to precertify services and they didn't, then if insurance says the bill is a write-off - it is.

2. Be very careful about "not paying." In my 16 years at my current job, I've heard lots of patients say "my attorney told me not to pay your bill" - but not once has an attorney taken any steps to undo bad credit reports if we'd turned the patient to collections. The attorney will tell us "cease and desist collections - I represent the patient in a lawsuit/Work Comp case" - no concern whatsoever about the patient's credit. We turn very few patients to collections, but the ones we do turn are usually the ones that don't respond to us.

I'm guessing, without seeing the bills I can't be sure, but it sounds like your insurance tried to deny the bill initially because you didn't "go to the nearest hospital." They might require precertification for non-emergency services (and they don't understand that your services were an emergency - ?), or proof of medical necessity for the emergency transport. If the transportation company does contract with your insurance, they should work this out themselves. But if they try and bill you, by all means notify insurance they did this since it would be a violation of contract. If the air transport doesn't contract with insurance, "walk it through" yourself - ie., call insurance and find out what then need from air transport, call air transport and tell them that insurance needs "x" from you, call insurance to make sure they receive it and are processing the claim - etc. I know it's a pain, but that's a big bill!

Good luck and let us know how it goes. Wish I could help more. The whole system is so frustrating.

FYI - The patient who sent us his medical bills had nearly a half million on his hospital bill alone. They discounted him - he owes $4000 now, which is still a bite, but they have a credit plan for him as well. He'll pay interest but no deadline to pay the whole thing off. He worked last year and is hoping to go back to work again soon. Healthcare providers do discount. Sometimes you have to ask, but private pay patients should not carry the load for insurance!

[jobob]

One of his bills was for helicopter transport from his local hospital to one of our city's hospitals. It was about 50 miles and the bill was $14,000.00. Just wondered how that compares with the distance you were transported?

Not a very good comparison IMHO.

You are trying to equate
(a) transport of a (presumably at least somewhat) stabilized patient from one hospital to another hospital, to
(b) emergency airlift of a potentially seriously injured patient from an accident site -- or as near to the accident site as the helicopter can land -- to a trauma center.

There's more at play here than simply mileage. At least in my case, mileage from the crash site to the trauma center (roughly 35 miles) was a very small part of the bill.

[OakLeaf]

Somewhat off topic, but precertification is no guarantee either. My insurance company precertified the PT I had for my hand several years ago and then denied the bill. Denied it on appeal, too. If it had been the size of a bill you have, I might've gone to court over it, but for "only" $1,000 out of pocket it wasn't worth it.

[Deborajen]

Not a very good comparison IMHO.

You are trying to equate
(a) transport of a (presumably at least somewhat) stabilized patient from one hospital to another hospital, to
(b) emergency airlift of a potentially seriously injured patient from an accident site -- or as near to the accident site as the helicopter can land -- to a trauma center.

There's more at play here than simply mileage. At least in my case, mileage from the crash site to the trauma center (roughly 35 miles) was a very small part of the bill.

It wasn't intended to be a direct, or rather all-inclusive, comparison. Just curious about the mileage part. But good point and good information.

Oakleaf, also a good point about precertification. Whenever you call an insurance company, they have a recorded disclaimer "this information does not constitute a guarantee of payment." I've seen insurance companies precertify, pay, then come back as much as a year and half later and say - wait, the patient wasn't really eligible for insurance. One particular patient had been a full-time student, but he dropped a class and became part-time. This was a patient who had brain surgery.

No, there are no guarantees. Just suggesting.