TULSA (AP) - A federal agency should investigate how a Texas company has been handling ambulance service claims because its alleged mismanagement could force emergency services in rural areas to close, an Oklahoma congressman said Tuesday.
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U.S. Rep. Dan Boren cited issues raised by ambulance services in Oklahoma and surrounding states about the denial or delay of claims by Dallas-based TrailBlazer Health Enterprises, a subsidiary of BlueCross and BlueShield of South Carolina.
"These rural ambulance providers form a critical health care safety net for thousands of Oklahomans," Boren, D-Okla., said in a statement. "It would be a disaster if these inefficiencies are responsible for emergency service companies closing their doors."
A spokesman for the company told the Tulsa World's Washington bureau that officials are reviewing concerns outlined in Boren's statement.
TrailBlazer handles claims for the federal Centers for Medicare and Medicaid Services for providers in Oklahoma and states in the region. Medicare and Medicaid reimbursements reportedly can provide 50 or even 70 percent of a local ambulance service's income.
"We cannot afford to wait until TrailBlazers mismanagement drives them out of business," he said. "They need to provide us some answers about their inefficiencies, their general lack of customer service, and their reluctance to address these issues."
Boren wants the federal Medicare agency to launch an investigation but said a congressional probe also is possible, spokesman Cole Perryman said.
Billy Quarles, a spokesman for the Texas company, said officials want to gather additional information about the complaints so they can review and discuss them.
"We take these concerns very seriously, and will work with Congressman Boren's office to ensure they are addressed," Quarles said.
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Blue Cross / Blue Shield, in my opinion, is little more than an organized crime racket.
I serve on two rural ambulance boards, one for Tillman County and the other our local Grandfield Ambulance Service. Trailblazer is killing us financially with denial of claims. Trailblazer seems to be all about themselves and is not service oriented or user friendly. This article is absolutely correct. If this problem is not fixed, rural ambulance services in Oklahoma will be forced to close leaving many communities without a golden hour to have emergency medical services for their families. I am glad Congressman Boren is causing an investigation to be made into this company. Without help from our government to protect and serve the public, this company will succeed in causing many ems to close. Meanwhile it leads to question whether this company is receiving bonuses from blue cross and blue shield for the money they save the insurance company. It would be life saving to have a company in this position seek to be a blessing to people instead of a curse. - Dwight Parker; Grandfield, Oklahoma -
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