DeRuyter (WSYR-TV) - A DeRuyter man has recovered from a severe wound, but several months later he's still fighting his insurance company over the flight to the hospital.
Despite a policy that includes coverage for air ambulance service, BlueCross BlueShield will not pick up any of the cost billed to John Ballard.
Paramedics were concerned with Ballard’s tremendous blood loss and possible skull fracture and decided he had to be flown to the hospital. BlueCross BlueShield won't cover any of the nearly $12,000 cost.
“They're sitting in their offices making this decision while out in the field blood is all over the ground, all over me, side of my scalp is laying over,” Ballard said.
He was cutting wood with his wife deep into the woods when a tree fell and hit him on the head. They took a four-wheeler about three quarters of a mile to where they could meet medical personnel.
Once first responders package him up, it was another four miles down the road to where they could meet the helicopter.
“I don't remember anything during the ambulance ride,” Ballard said. “I remember the smells of the helicopter when they were loading me to the helicopter. I don't remember anything beyond that until I was in the hospital getting staples."
His niece, Bobbiejo Becker, was at the scene. “It's odd, too, because my aunt actually looked at me, she goes, ‘oh my god, will my insurance pay for that?’ and I said, ‘yeah they should.’"
However, it’s not being covered and the company has denied Ballard's multiple appeals.
Becker said, “When she told me they denied it I was dumb founded. He was just losing so much blood and they are sitting behind a desk. They weren't here. They don't know what was going on."
Ballard wonders how he will pay the bill. “I don't have the money and we live paycheck to paycheck out here,” he said.
BlueCross BlueShield is citing patient privacy, saying it can not talk about Ballard’s particular case. In general, the company says health insurance coverage for air ambulance transport depends on the member's contract benefits and meeting medical necessity criteria.
Ballard says he was told the flight was medically necessary by the medical crew at the scene.
His case was appealed to the state, but they also denied his claim for coverage of the helicopter flight.
