Sara England was putting together Ghostbusters costumes for Halloween when she noticed her baby wasn't doing well.
Mar 25 2024KFF Health News Sara England was putting together Ghostbusters costumes for Halloween when she noticed her baby wasn't doing well.
According to England, late that night, when doctors said the baby was stable enough to travel, his medical team told her that a bed had opened up at the University of California-San Francisco Medical Center and that staffers there were ready to receive him. According to its coverage denial letter, Cigna determined that Amari's air-ambulance ride was not medically necessary. The insurer cited its reasoning: He could have taken a ground ambulance instead of a plane to cover the nearly 100 roadway miles between Salinas and San Francisco.
When KFF Health News asked Cigna what records were referenced when making this decision, a spokesperson declined to respond. In a letter to federal health officials, the group cited reasons commonly given for inappropriate medical-necessity denials observed by some of its 2,000 members, such as "the patient should have been taken elsewhere" or "the patient could have been transported by ground ambulance."
"The hospitals who live and breathe and work in our communities should be considering the individuals who come to them every day," Kelmar said. "I understand in emergency situations you generally have a limited amount of time, but, in most situations, you should be familiar with the plans so you can work within the confines of the patient's health insurance.""As parents, we did not make any of the decisions other than to say, yes, we'll do that," she said.
Andrea Rosenberg, a spokesperson for Natividad Medical Center, said the hospital focuses on "maintaining the highest standards of health care and patient well-being." "It's just another stress," she said. "Another thing to get in the way of us being able to enjoy our family."