AVIATION AND BILLING

Your air ambulance operation answers to an aviation regulator and a billing regime at the same time.

An air ambulance is an aircraft configured and staffed to move patients, either from the scene of an incident or between hospitals. It is a dual regulated business: the aviation side sits under federal aviation rules covering the aircraft, the crew and the operating certificate, while the clinical and billing side sits under health payment rules. The two regimes measure entirely different things about the same flight.

An operations director reviewing a combined flight and patient transport record for an air medical mission on a base office screen, used to show where aviation and clinical records finally meet.
Two regulators, one flight, and usually two separate records of it.
270,000helicopter patient transports reached by 2008
80 percentof air ambulance aircraft that are helicopters
135operating part for helicopter air ambulances

Neurobird Air Ambulance in short

  • Hold the flight and the patient encounter as a single transport record rather than two reconciled ones.
  • Track crew currency and aircraft status against the transports they were used for.
  • Capture the billing factors at the time of transport, since disputes ask for them later.
  • 270,000 Helicopter air ambulance patient transports rose from just over 200,000 to more than 270,000 across the decade to 2008. GAO-10-907
  • 35 percent That represented growth of about 35 percent in helicopter patient transports over the same period. GAO-10-907
  • Pricing runs 190 to 960 US dollars per month across 3 tiers. Early access is free.
The daily reality

What air ambulance operators and hospital flight programmes actually deal with

Flight records and patient records live in separate systems and have to be married up for every claim.
Crew currency and aircraft airworthiness are tracked by operations while billing chases the same flight separately.
Payment disputes later ask for factors that nobody thought to capture at the time of the transport itself.

Why it stays broken

Aviation software tracks tails, hours and crew currency. Clinical software tracks patients. The billing regime asks about the transport as a single event with attributes drawn from both, including quality and outcome measures of the provider that furnished the service. No system holds the flight and the patient encounter as one record, so every claim is a reconciliation.

80 percent of air ambulance aircraft are helicopters, which is why rotorcraft operating rules dominate the compliance picture.

An OCC is required for operators conducting helicopter air ambulance (HAA) operations with 10 or more HAAs and is recommended for other operators.

FAA Advisory Circular 135-14B, source
What it does

Neurobird Air Ambulance Dispatch Platform

One record per transport that carries the aircraft, the crew, the clinical encounter and the billing attributes together.

  • 1Hold the flight and the patient encounter as a single transport record rather than two reconciled ones.
  • 2Track crew currency and aircraft status against the transports they were used for.
  • 3Capture the billing factors at the time of transport, since disputes ask for them later.
  • 4Keep the documentation a payment dispute will request in one retrievable place.

What changes with Neurobird Air Ambulance?

The same work, read left to right: how it runs today, and how it runs once the record is in one place.

Air ambulance: current practice compared with Neurobird Air Ambulance
TodayWith Neurobird Air Ambulance
Flight records and patient records live in separate systems and have to be married up for every claimHold the flight and the patient encounter as a single transport record rather than two reconciled ones.
Crew currency and aircraft airworthiness are tracked by operations while billing chases the same flight separatelyTrack crew currency and aircraft status against the transports they were used for.
Payment disputes later ask for factors that nobody thought to capture at the time of the transport itselfCapture the billing factors at the time of transport, since disputes ask for them later.

Who is this for?

Three places the aviation record and the clinical record fail to meet.

Independent operator

One flight, two systems

The aviation record proves the aircraft and crew were legal. The clinical record proves what was done for the patient. A claim needs both, and reconciling them per transport is a recurring administrative cost that scales with volume.

Hospital flight programme

Rotorcraft rules dominate

Helicopters make up more than 80 percent of air ambulance aircraft, and federal law addresses helicopter air ambulance operations specifically, including safety improvements for crew, medical personnel and passengers on board.

Billing team

Factors captured too late

Payment determination for air ambulance services considers defined factors including quality and outcome measurements of the provider that furnished the service. Those are far easier to evidence if they were recorded at the transport rather than assembled during a dispute.

What the numbers say about air ambulance operations

The figures below come from federal oversight of the sector. The aviation ones and the billing ones describe the same flights from different directions.

270,000

Helicopter air ambulance patient transports rose from just over 200,000 to more than 270,000 across the decade to 2008.

GAO-10-907
35 percent

That represented growth of about 35 percent in helicopter patient transports over the same period.

GAO-10-907
80 percent

Helicopters make up more than 80 percent of air ambulance aircraft, carrying patients from incident scenes and between hospitals.

GAO-10-907
part 135

Federal law addresses safety for crew, medical personnel and passengers on helicopters providing air ambulance services under the relevant operating part.

49 U.S.C. 44730
2022

The federal advisory committee on air ambulance and patient billing issued its recommendations in 2022.

US Department of Transportation

How does Neurobird Air Ambulance work?

  1. Dispatch

    A transport opens one record covering aircraft, crew and patient, so the flight and the encounter never diverge into separate histories.

  2. Fly and treat

    Operational and clinical detail attach to the same transport, which is the unit both regulators and payers actually reason about.

  3. Bill and defend

    Billing attributes are captured at the time rather than reconstructed, so a payment dispute is answered from the record.

Interactive preview

See it work

A short walk through a transport from dispatch to claim.

Transport record workspace
Unassigned (5)
Operations director
Flight nurse
Billing analyst

Drag a job onto a director to assign it.

Air ambulance software questions, answered

Key terms

What is an air ambulance operation?
It is an aircraft operation configured and staffed to transport patients, either from an incident scene to a hospital or between facilities. The aviation component covers maintaining and piloting the aircraft and is regulated federally, while the medical component covers the clinical care delivered in flight. Oversight is therefore split: one regulator is concerned with whether the aircraft and crew were legal to fly, another set of rules with how the service is paid for.

Why do helicopters dominate the sector?

Because of the mission profile. Helicopter air ambulances transport patients from the scene of an accident to a hospital, or perform short distance transfers between hospitals, and they make up more than 80 percent of air ambulance aircraft. Federal law addresses helicopter air ambulance operations specifically, including measures aimed at the safety of flight crew, medical personnel and passengers on board.

How much has the sector grown?

Substantially, at least over the period federal auditors examined. Between 1999 and 2008 the number of patients transported by helicopter air ambulance rose from just over 200,000 to more than 270,000, an increase of about 35 percent, alongside growth in the number of dedicated air ambulance helicopters. Those figures describe that decade rather than the present day, but they explain how the sector reached its current shape.

What do payment disputes look at?

Defined factors specific to air ambulance services. Payment determination considers information including quality and outcomes measurements of the provider that furnished the service, and the rules recognise additional circumstances particular to air ambulance work. The practical implication for an operator is that the evidence supporting a claim is easier to assemble if it was captured at the time of the transport.

Is the software available now?

No. It is in development and open for early access. We are building the single transport record with operators who currently reconcile two systems for every flight.

Why we are building this

Air ambulance is one of the few businesses answering fully to two unrelated regulators about the same event.

The aviation side wants to know the aircraft and crew were legal. The payment side wants to know what was done for the patient and what factors justify the charge. Operators end up keeping two records of one flight and marrying them up afterwards, every time.

So we are building the transport as a single record. The Neurobird Team is starting with operators who already know how much of their administrative cost is reconciliation.

Neurobird Team neurobird.com

Where the requirement comes from

The rules that govern the aircraft, the crew and the claim.

How much does Neurobird Air Ambulance cost?

Early access pricing, held for the first 12 months for operators who help shape the build.

Single base
$190
per month
  • Transport records
  • Crew and aircraft linkage
  • Billing attribute capture
Join early access
Operator
$480
per month
  • Multiple bases
  • Dispute evidence export
  • Currency tracking
Join early access
Programme
$960
per month
  • Hospital programmes
  • Retention policy
  • Direct support
Talk to us
10 early access places

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We want operations directors who reconcile a flight record and a patient record for every claim.

Straight answer on where this is: The software is unfinished. Transport records, crew linkage and billing attribute capture work. There is no flight following integration and no clearinghouse connector yet.

Prefer email? Write to office@neurobird.com and a person will reply. No autoresponder.