I signed a paper and the air ambulance either billed directly or I do believe it was a third party (that was not your third party) that billed insurance, and I eventually got an EOB in the mail saying everything was paid.  I don’t believe I ever even got a direct bill or statement from the air ambulance company.  

Just reviewed my insurance EOB online which was updated from the paper one.

Billed 87K by air ambulance across two unexplained line items (helicopter transport and flight nurse crew, maybe?)

Insurance originally knocked it down to 56.5K.

Says on the updated online statement that insurance actually eventually paid 13K.  


Was about 100 mile ride, of course a weekend night, pilot plus 2 nursing crew plus whatever magic little ICU pod/instruments that were necessary.

In the end it was painless, already hit out of pocket max through other bills and the air ambulance people never called or mailed or bothered after sending the 15 page packet of weirdness upfront.  Mail back a few pieces of paper and that problem went away.  I think a change in federal law a few years ago made emergency air transport a required covered cost under insurance.