Woman wakes up to 65k medical bill because emergency helicopter ride for sudden cardiac arrest was not "pre-authorized"

[ck4829]

WASHINGTON — When Amanda Boley suffered cardiac arrest, she needed life-saving emergency transport to the nearest trauma center. Six weeks later, while still recovering, she received a $65,000 bill after her insurance company denied coverage.

"I woke up, I had IVs everywhere out my neck, my arms, I was intubated, my arms were restrained to the bed," Boley said. "And I remember looking and I knew immediately this is a hospital."

Six weeks later, still recovering from her ordeal, Boley received a $65,000 bill for her emergency helicopter transport. Her insurance company, Anthem, denied coverage stating Boley needed "pre-authorization" for the flight.

"That night I was dead and then I was unconscious," Boley said. "I don't know how I'm supposed to get pre-approval."

https://www.wusa9.com/article/news/investigations/medical-billing-artificial-intelligence-anthem-insurance-public-interest-research-group-patricia-kelmar/65-69dd3af8-c4aa-4898-b757-0e173a8ca2e9

[exboyfil]

1. She got denied twice and it was only reversed after the media got involved

After WUSA9's sister station in Indianapolis fought the $65,000 bill on Boley's behalf, Anthem suddenly reversed course, admitting they made a mistake and covering the bill in full.

Boley says she is relieved but not reassured it won't happen to someone else.

"When people have a medical crisis happen they should be allowed to heal. They should not have to worry about struggling to make ends meet so that the insurance company can profit," she said.

According to PIRG, when patients fight back, they usually win. As many as 75% of appeals result in overturned denials. However, many consumers don't know how to navigate the system.


So private enterprise runs healthcare better than the government? Denied patients should be compensated for their time.

[ck4829]

2. A good lesson for what do, call them up and say you're with Channel 6 or whoever