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Putting patients at financial risk: New UMMC AirCare vendor not covered by any Mississippi insurer

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The last thing anyone thinks about during an emergency is the cost of getting a severely injured patient to a hospital that can provide life-saving care.

When it comes to services such as air ambulances, however, saving a life could cost the victim and their family tens of thousands of dollars.

The only level one trauma center in the state is at the University of Mississippi Medical Center in Jackson. For Vicksburg and Warren County—all Central Mississippi, in fact—the fastest way to get a patient to UMMC is by AirCare helicopter ambulance, a service that most health insurance plans cover, at least to some extent, when those services are in-network.

Of course, emergency patients are rarely able to ask whether an ambulance is in their insurance network or to demand that service be provided only by those that are in-network. Ambulance services, at the same time, don’t limit responses to patients whose insurance includes them.

For AirCare trips, it may be irrelevant in every case. In May, UMMC is changing its vendor for AirCare, reports WAPT, and the new vendor, Med-Trans, is out-of-network for every private health insurance provider in Mississippi.

“We’re currently working with our partners at UMMC to negotiate an agreement with (Blue Cross Blue Shield),” Med-Tran’s Robbie Copeland told the station.

About two-thirds of air ambulance trips in 2017 were out-of-network, a 2019 Government Accountability Office report revealed, much higher than ambulance trips in general. Bills to cover the difference between what insurance pays and the total bill, called balance billing—or more popularly “surprise” billing—can threaten patients’ bank accounts.

“Privately-insured patients transported by air ambulance providers outside of their insurers’ provider networks are at financial risk for balance bills—which … are for the difference between prices charged by providers and payments by insurers,” the report’s authors wrote. “Any balance bills are in addition to copayments or other types of cost-sharing typically paid by patients under their insurance coverage.”

An air ambulance trip averages about $36,400, the GAO report states. Of 60 complaints the authors reviewed, all but one complained about balance billing in excess of $10,000.

The high end of the balance billing complaints was $66,000. In one example from North Dakota, the air ambulance provider charged $41,400, and the patient’s insurer paid only $6,700, leaving a balance of approximately $34,700.

The Mississippi Department of Insurance says on its website that the average air ambulance trip is 52 miles, about the distance from Vicksburg to Jackson, and costs between $10,000 and $25,000.

“The emergency nature of most air ambulance transports, as well as their relative rarity and high prices charged, reduces the incentives of both air ambulance providers and insurers to enter into contracts with agreed upon payment rates, which means air ambulance providers may be more often out-of-network when compared with other types of providers,” the report states.

Copeland indicated that Med-Care will work with patients to help them if their insurance denies their claims.

“Generally, officials from air ambulance providers we spoke to said that they first encourage patients to appeal to their insurers for increased payment,” the GAO report states. “If these appeals do not fully address the balance bill, the providers may offer various payment options. For example, officials from one air ambulance provider said that it offers a discount of up to 50 percent off the balance bill if the patient pays the remaining 50 percent immediately.”

Even with discounts, however, a patient can still be on the hook for tens of thousands of dollars.

On the national level, Congress is making an attempt to rein in balance billing, which can affect all kinds of hospital services, not just ambulance services. Doctors, hospitals and insurers—including air ambulance services—pushed back to protect their bottom lines against bills proposed in 2019, effectively killing the legislation, and their political action groups are donating heavily to 2020 campaigns.

The latest draft bill from the House Ways and Means Committee released earlier this month does not propose to ban balance billing from air ambulance providers, only to require reporting of cost data.

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Alexus Stirgus helps folks get and stay fit with ‘We Workin’

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(Photo courtesy Alexus Sturgis)

Former Vicksburg High School girl’s basketball standout Alexus Stirgus launched her personal training business, “We Workin,” in an effort to create a healthier community.

Stirgus graduated from Vicksburg High in 2010 where she was one of the lead scorers on the girl’s basketball team in its successful 16-9 2010 season. She scored a career high of 35 points in a game against NorthWest Rankin that year.

After her senior season at VHS, Stirgus went on to play basketball at Copiah Lincoln Community College. She led Co-Lin to a state title and a regional championship in the two seasons she played there. In 2012, Stirgus moved on to play for Mississippi College where she averaged 12.2 points per game.

After graduating from MC in 2014, Stirgus created “We Working” the following year to provide personal training to people seeking a healthier lifestyle.

“I want to help people branch off their negative habits and replace them with positive ones,” Stirgus said.

Stirgus trains some clients who suffer from obesity, but with hard work and dedication, she is helping them find a better and healthier way to live. She has about 15 clients she trains individually and sometimes in groups, and another 15 that she trains in basketball skills, both male and female.

“Many people I train have been unmotivated, so I try to help them, both physically and mentally, prepare to meet their goals,” Stirgus said.

Stirgus has put in countless hours into helping individuals who seek change for the better.

“We Workin” has truly lived up to its name as many people have seen Stirgus working with adults and children at Wyatt’s Gym.

Besides training individuals, Stirgus is now also a graduate assistant with the women’s basketball team at her alma mater, Mississippi College.

For more information, visit the We Workin Facebook page.

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Vicksburg clinics take proactive steps to limit patient exposure to COVID-19

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Mission Primary Care on Mission 66 and Medical Associates of Vicksburg on South Frontage Road have modified their scheduling and routine procedures in response to the COVID-19 crises.

The clinics see their actions as proactive to limit their patients’ exposure to the virus.

At Mission Primary Care, morning appointments are now reserved for patients with regular medical needs such as blood pressure monitoring and medication refills, said Dr. Carlos A. Latorre, who practices family medicine at the clinic. Afternoon appointments are for folks with cold and flu symptoms, including coughs, breathing difficulties and especially fever, typical symptoms of the COVID-19 virus.

The clinic is asking those with symptoms to please call ahead at 601-636-1050. It is strictly limiting the number of persons in the facility at any one time.

Latorre says that the symptoms of flu and COVID-19 are hard to differentiate. In addition to using the nasal swab test for flu, he may order a chest X-ray to look for signs of pneumonia.

Debby Runnels, the administrator at Medical Associates of Vicksburg and a registered nurse, said they are asking patients to call ahead as well at 601-262-1000. Patients will be connected to a trained staff member to be pre-screened by phone. When they arrive for their appointment, patients are asked to wait in their vehicles and call in. A staffer will escort them to specially designated rooms for evaluation and treatment.

Runnels said symptomatic patients are screened for cold and flu before a decision is made to administer the COVID-19 test. The tests are unpleasant, she said, but the procedures are necessary.

Latorre and Runnels both said there are a limited number of test kits available in the Vicksburg area.

Latorre believes that will change when the federal coronavirus taskforce led by Vice President Mike Pence puts pressure on providers to accelerate production.

A critical part of the kit is the packaging for transport to a lab. Samples must be correctly sealed and kept within a narrow temperature range to preserve their integrity. Results are generally available within 48 to 72 hours, but recently the labs have taken as long as five days. To date, about 600 Mississippians have been tested with 50 positive results.

A bigger issue are the few laboratories that can test the samples in Mississippi. Latorre said the Mississippi State Health Department can process around 200 samples per day, while independent LabCorp can test between 400 and 500 per day. Quest Diagnostics, another independent lab, should be online within a few days with similar capacities as LabCorp.

As test kits and labs become more available, Latorre expects to see an increase in testing statewide. At that juncture he anticipates MSDH will move into more of an oversight and crisis-management role.

Both health providers urge the public to follow the common-sense recommendations of state and federal health agencies such as the Centers for Disease Control and Prevention: Wash your hands often, stop touching your face, respect social-distancing directives and stay home if you’re ill among them.

They also expressed concern for those 65 and older and those with compromised immune systems. Both groups are at elevated risk of dying from COVID-19.

For more information on COVID-19, including prevention tips, visit the MSDH and CDC websites.

Merit Health River Region CEO Benjamin Richaud did not return our calls for this story.

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Mississippi reports two more cases of COVID-19 coronavirus

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(Image by Felipe Esquivel Reed, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=87846813)

From the Mississippi State Department of Health on Friday, March 13.

Today, the Mississippi State Department of Health reports the second and third presumptive positive cases of coronavirus, or COVID-19, in Mississippi. Final verification will come from the Centers for Disease Control and Prevention.

One case is a Forrest County adult female over 65 who recently traveled to North Carolina. The patient has been hospitalized. The other case is a Forrest County adult male who recently traveled to Florida and has been self-isolating at home without hospitalization.

The first presumptive case was reported Wednesday night in an adult male from Forrest County.

“We are conducting further investigation to determine if and how these cases might be connected to the first presumptive case. At this point, that is not clear, but we are thoroughly exploring all possibilities,” said MSDH State Health Officer Thomas Dobbs, MD, MPH.

Dobbs announced Thursday that MSDH is expanding access to COVID-19 testing that will allow physicians to submit specimens to the Mississippi Public Health Laboratory or commercial labs without prior consultation with MSDH. If individuals are worried about having COVID-19, they should call their healthcare provider.

Additionally, Dobbs said the MSDH is expanding recommendations for long-term care visitors and large social gatherings.

“We know that this virus is easily spread person to person, so we recommend limiting visitations and discontinuing any group social activities in long-term care facilities,” he said.

MSDH also recommends that individuals should avoid gatherings of more than 250 people and take precautions when they are in public. Communities and organizations should take the current coronavirus situation into account in planning or canceling events.

“Stay informed of the cases in your county and surrounding counties, and maintain social distancing as practical,” said Dobbs. “Our older population and chronically ill individuals, who are especially at risk, should protect themselves by avoiding gatherings of more than 250 people.”

There is no recommendation at this time that schools should close. Complete details of the updated information and guidance are available on the MSDH website.

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