The Trump administration has taken steps to limit patients’ personal spending on coronavirus screening and treatment, using relief funds to reimburse providers for bills from uninsured patients. Insurers are required to cover patients’ coronavirus tests without cost sharing or co-payment. Alex Azar, the secretary of health and social services, reiterated this commitment in an interview on CNN on Sunday, saying: “If you are not insured, it will be covered by us. “
The Texas group’s test experience suggests that it doesn’t always work that way. Some emergency rooms charge cash prices and set test fees that insurers are not required to cover. In this case, the patient who paid in cash received the best offer. Harvey has health insurance, but felt it would be a “hassle” to use it for the coronavirus test. So he paid for his test with two $ 100 bills after receiving the nasal swab and was on his way.
Ms. LeBlanc let the emergency room take a picture of her insurance card. She ended up with $ 6,408 in fees, mostly from an outside laboratory called Genesis Laboratory that managed her tests. She received explanations of benefits suggesting that she owed more than $ 1,000.
Jay Lenner, who also took a driving test with the same provider, used his insurance and received a similar charge list. He remembers a supplier saying he would only be tested for coronavirus, but billing records show that he has also been screened for Legionnaires’ disease, herpes and enterovirus, among others.
The emergency room also charged him $ 1,684 for the use of his premises and $ 634 for seeing one of his doctors. All told, he ended up with $ 5,649 in invoices, of which his insurance plan paid $ 4,914. Mr. Lenner did not cling to all of this, but he is still frustrated. “In the end, we pay this in higher premiums,” he said.
Austin Emergency Center spokeswoman Michelle Tribble said she has to charge high prices because insurers often pay only a small part of their fees.
“For emergency room visits, reimbursement from insurance companies generally represents one-fifth or one-third of the total,” she said. “If an insurance company billed a patient for an off-grid visit to our emergency room, our billing company would go to that patient and appeal on their behalf.”