New York hospital reviews billing practices after patients mistakenly charged for ED COVID-19 testing

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A New York hospital is reviewing its billing practices after several patients complained about receiving bills above $1,000 for COVID-19 tests in its emergency department. 

Patients of St. Francis Hospital & Heart Center in Roslyn, N.Y. told ABC 7 they were blindsided by the bills. Lisa Marschall said she was faced with a $1,800 bill for COVID-19 testing, and another patient said she was charged nearly $10,000 for four COVID-19 tests after visiting St. Francis Hospital's ED.

The costs of the COVID-19 tests are just $100, according to the hospital's website, but patients were also charged an emergency room fee of $1,545. This emergency fee is not disclosed on the hospital's website about COVID-19 testing.

Charles Lucore, MD, president of St. Francis Hospital, told Becker's Hospital Review that the hospital is obligated from a quality, safety, regulatory and liability perspective to provide complete medical evaluations to patients who come to the ED for any service, including COVID-19-related services and testing. As a result, the hospital charged the patients for a level 3 ED visit.

Under current law, providers can submit claims to insurers for COVID-19-related services and testing, but insurers are not supposed to pass along these costs to patients.

Section 6001 of the Families First Act, which was amended by the Coronavirus Aid Relief and Economic Security Act, requires private health plans to cover COVID-19 testing and the administration of that testing without member cost-sharing. The coverage also extends to services provided during a medical visit that results in COVID-19 testing or screening. These coverage protections are in effect until the public health emergency ends.

Despite these protections that should have prevented any out-of-pocket costs from being passed on to the patients, St. Francis patients still received bills for the services. 

Dr. Lucore told Becker's that he immediately launched an investigation into the billing errors after learning about them and found that some of the bills resulted from insurers mistakenly applying charges related to COVID-19 testing and COVID-19-related services to patients' deductibles.

Dr. Lucore said that the hospital is working with the insurers to get the charges to patients retracted and covered.

"We have and continue to contact any patient who [may] have inadvertently been billed and [are] working with their payers to resolve the issue," Dr. Lucore told Becker's. "Cigna, for example, has already rectified their error in assigning responsibility to the patient and has cleared the charges."

Dr. Lucore added that patients are not responsible for any out-of-pocket expenses for these services. 

"We're not going to collect anything for pandemic-related services," Dr. Lucore said. "That is not our intent."

Dr. Lucore added that patients who received bills for COVID-19 testing were not pressed to make payments, and no one was sent to collections.

Dr. Lucore said that the billing issue revealed that in addition to updating clinical services to respond to the pandemic, billing practices related to COVID-19 services need to be updated.

"It was a good lesson for us," he said.

St. Francis said it will review its billing practices to avoid any future confusion and plans to increase communication to patients about COVID-19 billing. The hospital already has updated its website to state that there is no cost for COVID-19 testing. It also plans to post signs in the ED and on patient statements that indicate they are not on the hook for COVID-19-related charges, Dr. Lucore said. 

The hospital's modified website reads: "Patients should not be responsible for any out-of-pocket expenses for these services. If however, a billing issue arises, we are committed to investigate the charges and will attempt to rectify the issue with the insurance carrier. We encourage patients to contact us if they have questions concerning their billing, and we will work with them and their insurers in an effort to resolve any issue."

 

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