Why Insurance Company denied paying for live saying Air Ambulance

It is a normal day for Amanda Boley, during her day she did her daily chores in home suddenly her heart stopped she fell down in her room, paramedics found her shifted her the hospital in a Air Ambulance, she was saved with the help of doctors , twist of the story is her Insurance company Rejected paying Air Ambulance Bill payment , why they denied paying ?

Full Story of Amanda Boley,

Amanda Boley, October 24, 2024, began like any other day in her quiet home in Hanover, Indiana. She brewed her morning coffee, fed her two cats, and sat on the couch with a book in hand. The crisp autumn air drifted through the open windows, and the day felt uneventful - until it wasn't.

Midway through folding laundry in the living room, Amanda felt an odd sensation - a wave of dizziness followed by a sharp, constricting pain in her chest. Her vision blurred, and before she could reach for her phone, her world went black. Minutes later, paramedics arrived at the scene, alerted by a neighbor who had heard the thud of Amanda's fall and rushed to call 911. They found her unresponsive with no pulse - a victim of sudden cardiac arrest.

The paramedics knew every second counted. Their equipment revived Amanda's faint heartbeat, but she needed specialized care that Hanover's small clinic couldn't provide. The nearest full-service hospital, equipped to handle such emergencies, was in Louisville, Kentucky, nearly 50 miles away. There was no time to waste. Amanda was quickly loaded into an air ambulance and flown to the hospital, the journey completed in just under 20 minutes. It was a race against time that ultimately saved her life.

"If it weren't for the helicopter, I'd be dead," Amanda boley

These are true feeling of Amanda about helicopter that saved her

At the hospital, Amanda underwent a series of life-saving procedures. Surgeons implanted a defibrillator in her chest to regulate her erratic heartbeat - a device that would serve as her constant guardian against future cardiac events. Waking up in a hospital bed days later, Amanda was disoriented but alive. Relief washed over her when the doctors assured her she would make a full recovery.

The financial fallout, however, was a battle Amanda hadn't anticipated. Weeks after her release, Amanda received a bill for the air ambulance service - a staggering amount that could threaten her financial stability. Confused, she reached out to her insurance provider, Anthem, only to be met with devastating news: the claim had been denied. Their reason? Amanda should have obtained preapproval for the air ambulance.

Reason why Insurance company denied paying "This service requires preapproval. Your plan doesn't cover this service without it. You are responsible for this amount."

it was mentioned in the rejected letter send by Anthem Insurance company

The absurdity of the situation left Amanda reeling. How could she have sought preapproval while unconscious and clinging to life? Despite her protests and clear evidence of the emergency, Anthem remained adamant. The rigid interpretation of their policy felt heartless, and Amanda's frustration turned into determination.

Amanda's story spread, drawing outrage from friends, family, and even strangers who rallied behind her. Advocacy groups took note, using her case to shed light on the systemic issues within the insurance industry. Legal experts stepped in to assist Amanda in her appeal, challenging Anthem's decision and pushing for policy changes that could prevent such injustices in the future.

Hanover Police Sgt. Kyle Pence was first to respond to the 911 call. He says “She was in no way, shape or form able to call to get preauthorization. She was unresponsive,” the officer said incredulously after learning of the denials.

Though the financial burden lingered, Amanda refused to be defeated. Her experience reshaped her into an advocate for those facing similar challenges. She vowed to fight - not just for herself, but for anyone who had ever been denied help in their darkest hours.

Boley contacted 13 Investigates to explain her struggle with the insurance company. 13News then contacted Anthem on Boley’s behalf, after further discussion Anthem accepted their error and released a statement .

We deeply regret the mistakes that led to the incorrect determinations and our leadership has been in touch with our member to offer our sincere apologies. Anthem Blue Cross and Blue Shield is committed to ensuring our members receive timely and appropriate care. We take our responsibility to our members seriously and we are taking immediate steps to improve our processes to provide the high-quality service they deserve. These steps include a more personalized, proactive, and high-touch approach to addressing complex situations like this one."

Anthem eventually covered the cost of Amanda Boley's air ambulance service, which amounted to $65,000. Initially, they denied the claim due to the lack of preapproval, but after public scrutiny and advocacy, they reversed their decision and paid the full amount. This case highlighted the challenges patients face with insurance policies during emergencies.