For instance, at the beginning of March a patient was instructed by the heads of a hospital emergency room and infectious-disease department to visit the emergency room for newly available coronavirus testing. In an isolation room, Mr. Cencini was put on an IV drip, had a chest x-ray and swabbed for the virus. According to the New York Times, the patient (who helps with computers in a prison for $54K per year and is a volunteer firefighter) was charged $2,000—the bulk of emergency room fees were covered by his insurer.
Coronavirus Emergency Room Charges
What emergency room charges does the insurer cover during this pandemic? Laboratories aren’t working for free. A spokesperson for the American Clinical Laboratory Association told the Times (March 30) that labs have completed over 234,000 tests to date, nearly quadrupled their daily test capacity and were “still waiting for reimbursement for tests performed. In many cases, labs are receiving specimens with incomplete or no insurance information, and are burdened with absorbing the cost.”
But emergency rooms are still charging patients, mainly because many in-network emergency rooms are staffed by doctors working for private companies. Mr. Cencini’s doctor works with Team Health, a medical staffing business owned by a private equity firm called Blackstone (In 2016, Blackstone paid $6.1 billion for Team Health.)
The new law that is meant to ensure aid to fight the effects of the pandemic seems to have overlooked ER charges related to coronavirus testing. Out-of-network medical billing has not been taken into consideration. Peterson-KFF, a health system tracker, explains that “surprise medical bills” occur when an insured person inadvertently receives care from an out-of-network provider. Last year, one in six visits to ER had at least at least one out-of-network charge, which increases the risk of patients’ receiving surprise medical bills, and hospitals demanding patient payment. A 2019 study in Texas showed that over 30 percent of ER doctor services were “out-of-network — and most of those services were delivered at in-network hospitals”.
READ MORE EMERGENCY ROOM CHARGES LEGAL NEWS
If you have a health emergency, and even if you are tested negative for coronavirus, the last place you want to be during this crisis is the emergency room. Chances are, you would be treated in an unfamiliar, out-of-network hospital because your hospital is too full with Covid-19 patients.