Air medical transport

Air ambulance operations software that closes the flight record before the claim goes out

An air ambulance is a helicopter or fixed wing aircraft configured and crewed to move a patient who cannot be moved safely by ground. In the United States most fly under 14 CFR Part 135, bill under the Medicare ambulance fee schedule at 42 CFR Part 414 Subpart H, and since 2022 resolve out of network disputes through a process that starts with 30 business days of open negotiation. Neurobird holds the request, the crew clock and the flight record in one place.

Air ambulance helicopter on a hospital pad with medical crew loading a patient, used to illustrate air medical transport operations
The flight is the easy part. The record is not.
135the FAA part most air ambulances fly under
2022No Surprises Act protections began
30business days of open negotiation before dispute resolution

Neurobird Air Ambulance in short

  • Log the request, the accepting facility and the reason for air transport at the moment the call comes in
  • Track duty period and rest against the aircraft assignment, not in a separate workbook
  • Close the flight record with loaded miles, point of pickup and medical necessity attached
  • Part 135 Most air ambulance flying happens under 14 CFR Part 135, the on demand and commuter operations rule, which sets crew qualification, weather minimums and maintenance obligations. eCFR, 14 CFR Part 135
  • 14 hours Part 135 flight and duty limitations cap the duty period and require defined rest, which is why the duty clock has to be visible at the moment an aircraft is assigned. eCFR, 14 CFR Part 135 Subpart L
  • Pricing runs 260 to 980 US dollars per month across 3 tiers. Early access is free.
The daily reality

What air medical operators and hospital based flight programs actually deal with

The communications center runs on a whiteboard and a radio, and the flight record is reconstructed after the crew lands.
Medical necessity, loaded miles and point of pickup all have to line up before a claim goes out, and they live in three different places.
Duty and rest limits are tracked in a separate spreadsheet, so the person assigning the aircraft is not the person who knows the clock.

Why it stays broken

Aviation software tracks aircraft and medical software tracks patients, and a transport is both at once. So the flight record gets rebuilt after the fact from a radio log, a run sheet and a 14 hour duty spreadsheet.

A missing point of pickup on 40 transports is 40 claims that stall before they are ever reviewed.

Information on the rules that prohibit providers, facilities and air ambulance providers from balance billing out-of-network patients, including for emergency services, air ambulance services, and for certain non-emergency services.

cms.gov, source
What it does

Neurobird Air Ambulance Dispatch Platform

Build the record in the order the job happens: request, assignment, flight, close. Then billing reads it instead of interviewing the crew.

  • 1Log the request, the accepting facility and the reason for air transport at the moment the call comes in
  • 2Track duty period and rest against the aircraft assignment, not in a separate workbook
  • 3Close the flight record with loaded miles, point of pickup and medical necessity attached
  • 4Hand billing a complete record instead of a chase list

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
The communications center runs on a whiteboard and a radio, and the flight record is reconstructed after the crew landsLog the request, the accepting facility and the reason for air transport at the moment the call comes in
Medical necessity, loaded miles and point of pickup all have to line up before a claim goes out, and they live in three different placesTrack duty period and rest against the aircraft assignment, not in a separate workbook
Duty and rest limits are tracked in a separate spreadsheet, so the person assigning the aircraft is not the person who knows the clockClose the flight record with loaded miles, point of pickup and medical necessity attached

Who is this for?

Same transport, three different exposures.

Independent operator

You own the aircraft

Every unbilled transport is your money. You need the record closed with loaded miles and point of pickup before the crew goes off shift.

Hospital based program

The health system owns the program

You answer to a compliance office and a finance office at once. You need medical necessity documented in the same record as the flight.

Multi base network

You run several bases

Aircraft, crews and payer contracts differ by state. You need one way of recording a transport across all of them.

How air medical transport is actually regulated and paid

Useful if you are standing up a base or arguing a claim. Each source links out.

Part 135

Most air ambulance flying happens under 14 CFR Part 135, the on demand and commuter operations rule, which sets crew qualification, weather minimums and maintenance obligations.

eCFR, 14 CFR Part 135
14 hours

Part 135 flight and duty limitations cap the duty period and require defined rest, which is why the duty clock has to be visible at the moment an aircraft is assigned.

eCFR, 14 CFR Part 135 Subpart L
414

Medicare pays ambulance transport, air included, under the fee schedule at 42 CFR Part 414 Subpart H: a base rate by aircraft type plus loaded mileage.

eCFR, 42 CFR Part 414 Subpart H
2022

No Surprises Act protections took effect for air ambulance, limiting patient cost sharing and pushing the balance to an independent dispute resolution process between plan and provider.

CMS, No Surprises Act
Published rates

CMS publishes the ambulance fee schedule and its air ambulance codes each year, which is the reference point most contract negotiations start from.

CMS ambulance fee schedule

How does Neurobird Air Ambulance work?

  1. Take the request once

    Requesting facility, accepting facility, reason for air transport and patient weight are captured at the call, not reconstructed later.

  2. Assign against the real clock

    Duty period, rest and aircraft status sit beside the assignment, so a 14 hour limit is visible before a crew is launched, not after.

  3. Close and hand off

    Loaded miles, point of pickup and crew signatures close the record, and billing gets a complete file rather than a chase list.

Interactive preview

The transport, as your comms center would run it

A working preview. Tick a line to move it through the flight record.

neurobird / air ambulance ops
Unassigned (5)
Comms Specialist Ruiz
Pilot Okafor
Billing Lead

Drag a job onto a crew to assign it.

Air ambulance software questions, answered

Key terms

What is an air ambulance?
An air ambulance is a helicopter or fixed wing aircraft configured and crewed to move a patient who cannot be moved safely or fast enough by ground. In the United States most operate under 14 CFR Part 135 as on demand air carriers, and the medical crew works under a separate clinical licence and protocol set.

Why is air ambulance billing so contested?

Because two rulebooks meet on one flight. The aircraft is regulated as an air carrier, the transport is billed as a medical service, and since 2022 the No Surprises Act moved out of network air ambulance disputes to an independent dispute resolution process with a 30 business day open negotiation window before either side can initiate.

What drives the payable amount on a transport?

Base rate plus loaded mileage, coded by aircraft type. Medicare pays air ambulance under the ambulance fee schedule at 42 CFR Part 414 Subpart H, with separate codes for fixed wing and rotary wing, and mileage counted from point of pickup to the receiving facility.

How do duty limits affect dispatch?

Part 135 flight time and rest requirements cap what a crew can accept, and a request that looks assignable can be unflyable once the clock is read correctly. Keeping the duty period next to the aircraft assignment is the difference between a turndown and a violation.

Does this replace our CAD or billing system?

No. It sits between them. The flight record is built once, in the order the job actually happens, then feeds whatever billing platform you already run.

Why we are building this

An air ambulance transport is two regulated activities happening at the same time. The aircraft answers to Part 135. The patient answers to a clinical protocol and a payer. Almost no software treats them as one event.

So programs run a whiteboard, a radio log, a paper run sheet and a duty spreadsheet, then rebuild the flight record afterwards from memory. That is where the money and the compliance risk both leak.

We would rather build this with people who have worked a comms desk. Tell us how your transports get recorded, and where we have got it wrong.

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?

Priced per aircraft because a base is built around airframes. Unlimited users and unlimited transports on every tier.

Single base
$260
per aircraft, per month
  • Request intake
  • Flight record
  • Loaded mileage capture
  • Crew duty clock
  • Email support
Request access
Multi base
$540
per aircraft, per month
  • Everything in Single base
  • Turndown and weather logging
  • Billing handoff file
  • Medical necessity capture
  • Named contact
Request access
Program
$980
per aircraft, per month
  • Everything in Multi base
  • CAD and billing integration
  • Multi state payer rules
  • Dispute resolution evidence pack
  • Onboarding included
Talk to us
First 15 programs get early access pricing locked for three years

Get free early access

If you run an air medical program, tell us how the flight record gets built today and where it falls apart.

Straight answer on where this is: In development. Early access gets the working preview, a say in what ships first, and early access pricing. It does not get you a login today.

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