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Four hundred and nine days ago, Sally's health insurance company told her they would not cover her air ambulance flight to be evaluated for a liver transplant. Last week, after four appeals and countless hours of work by Angel MedFlight's patient advocates, that decision was reversed. The insurance company will now pay the full amount of the services provided by Angel MedFlight.

In December, 2008, Sally, was suffering from end stage liver failure. Her doctors told her she needed to receive a liver transplant evaluation in order to get on the transplant list. Travel by ground ambulance or a commercial flight were not an option for Sally due to her condition. Nevertheless, her health insurer refused to approve the flight on the grounds that it was "not medically necessary."

At that point, she was faced with two options: (1) giving up the chance of a transplant, or (2) taking the time to try and raise thousands of dollars for the flight. Sally may have had options but, sadly, Sally did not have extra time. That is when Angel MedFlight stepped in, reviewed her insurance policy, and conducted the flight.

"When health insurance companies deny authorization every air ambulance company runs for the hills," said Jeremy Freer, Angel MedFlight CEO. "If they cannot get paid in advance, either from insurance or from the patient's family, they will not conduct the flight. That's one of the big differences that sets apart Angel MedFlight. We will provide the care needed by the patient, when no one else will."

After conducting the flight, Angel MedFlight's legal team, led by attorney Kelly LoCascio, Esq., went to bat for Sally. The claim was governed by the Employee Retirement Income Security Act of 1974 or ERISA, a federal law governing most health insurance policies that even most lawyers do not understand.

"Unfortunately, health insurance companies frequently deny coverage for health benefits when they should be paid," said LoCascio. "They deny claims knowing the patient will not understand the intricacies of ERISA law, are too involved with their health, or just get tired of the fight which forces the patient to miss crucial appeal deadlines, and do not have the resources to hire a lawyer. We take on the battle so our patients don't have to. In Sally's case, the system worked, Angel MedFlight performed the service, the insurer denied benefits, and after much exhaustive efforts Angel MedFlight ensured that BlueCross BlueShield carried out their obligations."

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