SANTA BARBARA, Calif - Most people call the NewsChannel 3 Tipline with a problem or complaint that's pretty cut and dry. In this case, a viewer called us to say that he had an interesting dilemma. He was being hounded, and threatened with collections by the same people who saved his life.
"I have no memory of the accident. I woke up on the tarmac. I just looked around. I had no idea who I was, where I was or what I was doing there," said Neil Myers during an interview with NewsChannel 3 in May.
Neil Myers is a Santa Barbara tri-athlete who defied the odds on August 4, 2018 while riding his bike on Gibraltar Road in the hills above Santa Barbara.
"Saturday afternoon, it was about 5 o'clock, came around a turn pretty quickly and there was a truck in my lane. There was no way I could avoid it. Hit it, went right through the windshield all the way to my ankles,” said Myers.
He broke 16 bones, had a collapsed lung, bleeding on the brain and lost about 70-percent of his blood.
”I could hear myself moaning, but I couldn't feel any pain because of the shock," said Myers.
That's when the first paramedics arrived and started working to save his life. Luckily, a helicopter had just dropped off a patient at Santa Barbara Cottage Hospital and was only minutes away.
"So the ground ambulance took me 500 yards from where I'd been injured to the air ambulance and the air ambulance took me four minutes down to Cottage. I'm incredibly grateful for that, it's part of why I'm here is because how quickly they worked. If it wasn't for Cottage, I'd have to go to UCLA or Stanford and I don't think I would have made it to either place," said Myers.
Myers told us 300 people along the way worked on him, saved his life and put him back together. He went home a month later. A few days later, he started thinking about the medical bills.
"It took me about 15 minutes to realize my insurance company had paid everything they'd seen, everything," said Myers.
Actually, Neil's insurance company paid everything it was obligated to pay and the truck driver's insurance company paid as well.
"And then I started getting letters from two companies, a ground ambulance company and an air ambulance company," said Myers.
American Medical Response or AMR, the ground ambulance company, received $726 from Neil's insurance company but it wanted almost $1,781 more. And Cal-Star, the air ambulance owned by Reach Medical was paid almost $18,968, but it wanted Myers to pay another $27,504 out of his pocket.
"And what the two companies, they are not related, were saying is, 'We're going to take you to collections if you don't pay this.' I talked to the insurance company, and they said, 'We've paid what we're going to pay,'" said Myers.
Myers told us that he knows how all of this works because he used to own Santa Barbara Air Charter Company. He tried to argue with the bill collectors that, even though the 500-foot ambulance ride and the four-minute helicopter ride, helped save his life they didn't cost $50,000, and he shouldn't have to pay that much.
"The head of emergency at Cottage spent four hours with me, and he saved my life. He got $750. I think you're getting enough," said Myers as he described a conversation he had with one of the bill collectors.
However, Myers said the bill collectors kept calling, so he picked up the phone and called the NewsChannel Three Tipline. We started working on it. We contacted AMR and Reach Medical Holdings on Myer's behalf. At our request, both companies agreed to review the bills and the services they provided to Neil Myers.
It took a few weeks, but Reach wiped out its entire air ambulance bill and so did AMR, in all, almost $30,000 in charges.
"I was at my wits end when I called you, as you recall a few months ago. And thanks to the work you guys did, we got people to look at it, and we got everything resolved. I couldn't be happier. Thank you so much for what you did," said Myers to NewsChannel Three.
The dilemma, in this case, was on paper. There is no doubt the AMR crew and the Cal-Star crew who responded that day played a big part in saving Myer's life, and they are heroes.
One of the best parts of this whole ordeal is that Myer's made a connection with the folks at both companies through all of this, and they are planning a reunion with the crews who saved his life. We've been invited to attend, and we will bring that to you when it happens.
Here's the full written statement sent to us by Cal-Star/Reach Medical Holdings President Sean Russell:
I am undoubtedly pleased with Mr. Myers' recovery. He is an extraordinary man who has shown great courage and resiliency under tragic circumstances. His story is not only a testament to that, but also to the effectiveness of the first responders, as well as the EMS and trauma systems in place in Santa Barbara County and the vital role that emergency air medical transport plays within those.
Air ambulance services are a critical component of every EMS and healthcare system, especially in rural communities where access to trauma care facilities is limited, and hospitals are closing at a rate of one per month. Unfortunately, due to insufficient insurance reimbursement rates, many providers of air medical services are being forced to scale back operations, close bases, and rely on balance billing practices, leaving rural communities and patients, like Mr. Myers, at risk.
We have a compassionate billing program in place that ensures our patients don't face financial hardship as a result of their transport, and a full-coverage membership program available in almost every community we serve. However, the underlying problem of insufficient reimbursement by the insurance industry still requires resolution.
Around 75 percent of patients transported by air medical providers have Medicare, Medicaid, other government insurance, or are uninsured. The reimbursement from these payers falls well below the actual costs of keeping air assets operational 24-hours a day, 365 days a year, with flight crews as extensively trained and experienced as ours.
In the state of California, payment for transporting a patient with Medi-Cal coverage only covers a small portion of the direct operating cost of a transport, because the reimbursement rate for air medical has not been adjusted since 1993.
There are several pathways to resolution. We need federal and state lawmakers to support the reexamination of the Medicaid and Medi-Cal reimbursement structures, to ensure that rates reflect the actual costs of service. We need the California State Senate to pass AB 651, which will help to supplement the costs that air medical providers incur as a result of insufficient Medi-Cal reimbursement rates. Finally, we need insurance companies to engage in honest and open discourse regarding reimbursement and begin working toward agreements that are fair to all parties, and that prioritize what is most important -- the care of patients in the communities we serve.