Advocating for the Patient

Advocating for the Patient

Anyone who has ever been flown for a life- or limb-threatening medical emergency can testify that the medical trauma is just the beginning. Those who survive the medical emergency are often caught off guard when their insurance companies start asking for more information or deny the medical claims all together.

Brittney Spomer works for a health insurance company in Texas, and she was surprised by how much time it took to get payment for the air medical flight.

Brittney and her husband spent eight years trying to conceive children. In the winter of 2018, Brittney – pregnant with twin boys – went into pre-term labor in Wichita Falls, Texas.

“I was at 24 weeks,” Brittney said. “They gave me medicine to stop the labor at the hospital, but it didn’t work.”

Brittney needed to get to a higher level of care quickly, before her twins’ lives were put in danger.

“It would have been a two-and a-half hour drive, but the flight was 45 minutes,” she said. “My husband is a firefighter/paramedic and he knew the Air Evac crew in Wichita Falls.” “I’d never been in a helicopter before, and I was already extremely anxious about these babies we’d waited eight years for.”

Flight Paramedic Ross Caston came into the room and reassured Brittney and her husband that the crew would do everything to keep Brittney and the babies safe and comfortable.

“I knew who was caring for me, and that put me at ease,” she said.

She remained in the Fort Worth hospital for five days before returning home. That flight got Brittney and the babies to definitive care in time for the medical team to stop her pre-term labor. Then came the denial from her insurance company, which caused more anxiety for Brittney – something she and the twins didn’t need.

“I work for the company that was denying the claim,” Brittney said. “I got an explanation and request for records in the mail, filled everything out and sent it in.”

The insurance company replied with partial payment and required more information. Brittney called the Air Evac Lifeteam Patient Advocates and spoke with Michele Lewis.

“They (insurance) needed something to show there was a 30-minute time savings in going by air versus going by ground,” Brittney explained.

Michele worked with Brittney for the next 17 months, dotting I’s and crossing T’s, to ensure the insurance company had everything it needed to pay the charges.

“I think she knew it wasn’t just about a claim,” Brittney said. “My patient advocate knew this was causing stress for me. My insurance should be backing me up and taking care of me and I felt like they weren’t. Having someone from the provider there to say, ‘You’re right. This isn’t how it should be.’ I had her helping me get it resolved. It was one thing I didn’t have to stress about, because I knew she was working for me. She cared enough to listen to me.”

The Spomer twins, John and Grayson are happy and healthy, something Brittney does not take for granted.

“Because of that flight, my boys held off until they could be born at 32 weeks and 5 days,” Brittney said. “I was able to give birth in Wichita Falls, and the boys were able to stay there too. They may not have survived at 24 weeks. Had I not had the Air Evac flight; this situation would have been totally different. We did eight years of infertility treatments, and it could have all been gone had the Air Evac crew not taken us to Fort Worth.”