Originally published on NYT – Health on 2020 06 29 by Sarah Kliff https://www.nytimes.com/2020/06/29/upshot/coronavirus-tests-unpredictable-prices.html
When it came to the kayakers and the coronavirus test bills, the patient who paid cash actually got the best deal. Mr. 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 photograph of her insurance card. She ended up with $6,408 in charges, mostly from an outside lab called Genesis Laboratory that handled her testing. She received explanation-of-benefit statements suggesting she would owe more than $1,000.
Jay Lenner, who also got a drive-through test from the same provider, used his insurance and received a similarly long list of charges. He recalls a provider saying he’d be tested only for coronavirus, but bill records show he was also screened for Legionnaires’ disease, herpes and enterovirus, among other things.
The emergency room also charged him $1,684 for using its facility and $634 to see one of its doctors. All told, he ended up with $5,649 in bills, of which his insurance plan paid $4,914. Mr. Lenner didn’t end up on the hook for any of it, but he’s still frustrated. “Ultimately, we pay for this in higher premiums,” he said.
Michelle Tribble, a spokeswoman for Austin Emergency Center, said it needed to charge high prices because insurers often pay only a small share of their fees.
“For emergency room visits, the reimbursement to us by insurance companies is typically a fifth or a third of total charges,” she said. “If an insurance company were to bill a patient for an out-of-network visit to our emergency room, our billing company would go to bat for that patient and would appeal on their behalf.”
Austin Emergency Center and Genesis Laboratory had differing explanations for why patients like Mr. Lenner were screened for so many conditions. Ms. Tribble said “the lab makes the determination” of what to test for. Edward Cienki, a spokesman for the laboratory, said, “Genesis does not order clinical laboratory tests.”