Updated: March 02, 2020 06:07 PM
Created: December 15, 2019 10:29 AM
ROCHESTER, N.Y. (WHEC) — A grieving family in Wayne County who lost everything in a fire, including their 4-year old son, got an unexpected surprise in the mail on the day they took the little boy off of life support.
“He was just a delight, he wore you out just watching him,”— that’s how Sandie Best describes her 4-year-old great-grandson, Kayden Bennet. Kayden was in his Lyons home with his parents and 10-year-old brother on Nov. 16 when he heard the smoke alarm go off. The little boy hid in the closet. It took Lyons firefighters more than 20 minutes to find him in the smoke and pull him from the burning home.
Kayden was transported to Strong Memorial Hospital via Mercy Flight Central and put on life support.
"He donated his liver, his kidneys, and his heart," Best says. "So, I'm in hopes that some other little one is running around with his heart because it's big."
It was six days after the fire that his family said goodbye, and the very same day, they got a notice in the mail from Mercy Flight Central warning them that the cost of his flight was just shy of $40,000, and Mercy Flight Central is not in Excellus Blue Cross Blue Shield’s Network.
“It's almost like they don't have a heart, I mean these are two people (Kayden’s mom and dad) that work every day, they try to raise their family, and they've lost every single thing they owned,” Best says.
Mercy Flight Central says the notice is not a bill even though it looks like one, and just because they are out-of-network, doesn’t mean Excellus BCBS won’t pay something toward the balance. But as News10NBC has previously reported, in many cases that “something” is between $5,000 and $8,000 and the rest of the bill falls to the patient, or in this case, his family.
“These poor kids will never get it paid down," Beset says of the bill. "It's awful."
The CEO of Mercy Flight Central, Jeff Bartkoski, told News10NBC in the past that the organization is not currently in any private insurers' networks but is working to change that. When customers are in a “balance billing” situation like Kayden’s family now is, Mercy Flight Central will work with them to discount the balance and offer payment plans.
But the situation with Mercy Flight Central is only half the story. A second air ambulance was called to the Lyons fire at Kayden’s house for his 10-year-old brother. It was a LifeNet NY helicopter. LifeNet NY is part of a national company that has a base in Seneca Falls and it is in-network with Excellus BCBS.
“We're really trying to increase our in-network strategy so we're basically trying to eliminate any out-of-pocket costs to the patient,” Tony Raymond, the Regional Sales Director tells News10NBC.
So, two different providers offering the same exact service to the same exact family with the same exact insurance… one ride will likely cost thousands of dollars out of pocket, the other completely covered after co-pays or deductibles.
News10NBC Investigative Reporter Jennifer Lewke followed-up with Mercy Flight Central:
Jennifer Lewke: Why do you think LifeNet NY can get into Excellus’s network and you can’t?
Jeff Bartkoski: LifeNet NY is part of Air Methods Corporation, an over $1 billion company. They’re the largest air medical provider in our nation, they have a significant amount of leverage in negotiations. So, I think the other side of the table may feel more compelled to make a deal.
Jennifer Lewke: I know it’s not a bill, but it looks like a bill and it arrived just six days after the flight happened. Is it typical to bill that quickly or let them know that hey, you might have this massive bill coming your way, that quickly?
Jeff Bartkoski: Our billing agency does try to contact the insurance company and get the invoice out right away.
Jennifer Lewke: But as a father, you can understand how that could be a kick in the stomach?
Jeff Bartkoski: Oh, absolutely. We have the privilege of impacting so many families in a positive manner but not every outcome is positive... We’ve tried to clarify that communication because the last thing we want to do is cause any additional concern for one of our patients or our patients' families.
Jennifer Lewke: It looks like a bill.
Jeff Bartkoski: I understand, I understand what you’re saying, but we’ve addressed that already.
Bartkoski says at this point, Mercy Flight Central and Excellus BCBS are meeting, “as recently as this week, we’ve had conversations with Excellus and all appearances to me is… we’ll get a deal done very soon.”
In a statement, a spokesman for Excellus BCBS tells News10NBC, “Air ambulance is an important service and we want our members to have access to air transportation when they need it. At the same time, it must be reasonably priced. We are in discussions with Mercy Flight Central about becoming a participating provider of air ambulance service. The affordability of air ambulance service especially when consumers are being balance billed is an issue across the country. Congress is close to voting on legislation to ban surprise medical bills. The proposed law specifically includes air ambulance providers. We believe real progress has been made and we hope the legislation passes quickly.”
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