# 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.

- URL: https://neurobird.com/airambulance/
- Product: Neurobird Air Ambulance Dispatch Platform
- Niche: air ambulance
- Buyer: air medical operators and hospital based flight programs
- Status: in development, open for early access
- Updated: 2026-08-21

## What Neurobird Air Ambulance does

- 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
- Hand billing a complete record instead of a chase list

## How it works

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.

## From the source material

> 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.

Source: cms.gov, https://www.cms.gov/nosurprises/policies-and-resources/provider-requirements-and-resources

## Industry context

- **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. (source: eCFR, 14 CFR Part 135, https://www.ecfr.gov/current/title-14/chapter-I/subchapter-G/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. (source: eCFR, 14 CFR Part 135 Subpart L, https://www.ecfr.gov/current/title-14/chapter-I/subchapter-G/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. (source: eCFR, 42 CFR Part 414 Subpart H, https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/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. (source: CMS, No Surprises Act, https://www.cms.gov/nosurprises)
- **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. (source: CMS ambulance fee schedule, https://www.cms.gov/medicare/payment/fee-schedules/ambulance)

## Pricing

- Single base: $260 per aircraft, per month
- Multi base: $540 per aircraft, per month
- Program: $980 per aircraft, per month

## Questions

### 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.

## Sources

- [14 CFR Part 135, on demand operations](https://www.ecfr.gov/current/title-14/chapter-I/subchapter-G/part-135)
- [14 CFR Part 135 Subpart L, flight and duty](https://www.ecfr.gov/current/title-14/chapter-I/subchapter-G/part-135/subpart-L)
- [42 CFR Part 414 Subpart H, ambulance fee schedule](https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-414/subpart-H)
- [CMS, No Surprises Act](https://www.cms.gov/nosurprises)

## Contact

- office@neurobird.com
- https://neurobird.com/