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COVID Catch-22: They got a big ER bill because hospitals couldn't test for virus

Julie Appleby, Kaiser Health News on

Published in Health & Fitness

Fresh off a Caribbean cruise in early March, John Campbell developed a cough and fever of 104 degrees. He went to his primary care physician and got a flu test, which came up negative.

Then things got strange. Campbell said the doctor then turned to him and said, "I've called the ER next door, and you need to go there. This is a matter of public health. They're expecting you."

It was March 3, and no one had an inkling yet of just how bad the COVID-19 pandemic would become in the U.S.

At the JFK Medical Center near his home in Boynton Beach, Florida, staffers met him in protective gear, then ran a battery of tests -- including bloodwork, a chest X-ray and an electrocardiogram -- before sending him home. But because he had not traveled to China -- a leading criterion at the time for coronavirus testing -- Campbell was not swabbed for the virus.

A $2,777 bill for the emergency room visit came the next month.

Now Campbell, 52, is among those who say they were wrongly billed for the costs associated with seeking a COVID-19 diagnosis.

 

While most insurers have promised to cover the costs of testing and related services -- and Congress passed legislation in mid-March enshrining that requirement -- there's a catch: The law requires the waiver of patient cost sharing only when a test is ordered or administered.

And therein lies the problem. In the early weeks of the pandemic and through mid-April in many places, testing was often limited to those with specific symptoms or situations, likely excluding thousands of people who had milder cases of the virus or had not traveled overseas.

"They do pay for the test, but I didn't have the test," said Campbell, who appealed the bill to his insurer, Florida Blue. More on how that turned out later.

"These loopholes exist," said Wendell Potter, a former insurance industry executive who is now an industry critic. "We're just relying on these companies to act in good faith."

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