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WEST VIRGINIA RECORD

Thursday, April 25, 2024

Couple sues Air Methods Corporation for excessive air-ambulance bill

Law money 07

PRINCETON – A couple is suing Air Methods Corporation and Rocky Mountain Holdings after they claim it charged them an excessive air-ambulance bill of more than $50,000.

On Aug. 21, 2015, the defendants transported Michael Cox and Tabitha Cox’s infant son, West Cox, from Princeton Community Hospital to CAMC Women’s and Children’s Hospital, according to a complaint filed Aug. 18 in Mercer Circuit Court.

The Coxes claim no oral or written contract was agreed upon between plaintiffs and defendants and, following transport, the defendants billed the Coxes a total of $52,634.76 and itemized the charge as a base charge of $28,887.04 and an addition $23,747.72 for the 76 rotor miles of transport.

The plaintiffs PEIA insurance paid a reasonable amount of $6,704.14 and advised the plaintiffs that their portion of the bill would be $586.79, according to the suit.

The Coxes claim they later received a bill for the amount of $45,930.62 for the remaining balance of the original $52,634.76 bill after PEIA’s payment.

In one of the bills, the defendants stated that the plaintiffs’ insurance had denied or underpaid and that the defendants had filed an appeal on the plaintiffs’ behalf, according to the suit.

The Coxes claim PEIA continued to deny the claim and, on May 6, 2016, a letter was sent to the plaintiffs from PEIA stating that the insurance company pays air-ambulance claims at the air-ambulance rates set by the Federal Medicare program and that other providers routinely accept the reimbursements as payment in full.

“With respect to your claim, PEIA has paid $6,704.14, what it believes to be a reasonable amount,” PEIA’s letter stated. :PEIA cannot agree to pay an additional $45,930.62. This amount is clearly excessive.”

The Coxes claim the amount sought by the defendants does not represent the reasonable value of services rendered and is excessive.

The defendants have breached their implied contract with the plaintiffs by not charging them and class members fair and reasonable value of its services and materials, according to the suit.

The Coxes are seeking compensatory damages. They are being represented by Eric J. Buckner of Katz, Kantor, Stonestreet & Buckner; and Jason E. Causey and James G. Bordas Jr. of Bordas & Bordas.

Mercer Circuit Court case number: 17-C-314

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