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As part of my reporting this year, I've read hundreds of bills for coronavirus tests.
Some of them are pretty big — over $1,000 for tests that patients thought would be free.
As testing numbers rise, here's a thread on how to avoid getting a surprise COVID test bill. (1/11)
Some of them are pretty big — over $1,000 for tests that patients thought would be free.
As testing numbers rise, here's a thread on how to avoid getting a surprise COVID test bill. (1/11)
Step One: Get Tested at a Public Site if You Can.
These are the sites set up by your state, county, or city. Those facilities are much less likely to generate any sort of bill.
(2/11)
These are the sites set up by your state, county, or city. Those facilities are much less likely to generate any sort of bill.
(2/11)
If you can, avoid getting tested at an ER or hospital. They tend to generate a higher number of surprise coronavirus test bills.
Why are these places a risk? They will often tack on a "facility fee," something @marshall_allen writes about here (3/11): https://www.propublica.org/article/how-a-covid-19-test-led-to-charges
Why are these places a risk? They will often tack on a "facility fee," something @marshall_allen writes about here (3/11): https://www.propublica.org/article/how-a-covid-19-test-led-to-charges
Step Two: Ask Your Provider What You'll Be Billed For.
Most surprise bills I see aren't about the COVID test itself. They're about something else the doctor tacked on — they tested the swab for other diseases.
Patients often tell me that had no idea that was happening (4/11)
Most surprise bills I see aren't about the COVID test itself. They're about something else the doctor tacked on — they tested the swab for other diseases.
Patients often tell me that had no idea that was happening (4/11)
Before you get tested, ask! What diseases are you testing me for today? Are you providing any diagnostics beyond the coronavirus test?
If your provider can't answer, perhaps a sign you want to look elsewhere for testing!! (5/11)
If your provider can't answer, perhaps a sign you want to look elsewhere for testing!! (5/11)
Step Three: Know Your Rights Under Federal Law
New federal law *requires* insurers to cover COVID tests without copay or deductible.
Get charged something like that? I would absolutely challenge it. You could also file a complaint with your state insurance regulator (6/11)
New federal law *requires* insurers to cover COVID tests without copay or deductible.
Get charged something like that? I would absolutely challenge it. You could also file a complaint with your state insurance regulator (6/11)
Federal law also requires insurers to cover services necessary to get the COVID test (i.e. the fee for the doctor visit). I've seen insurers sometimes inaccurately deny those charges.
Again, I would challenge that denial and possibly tell a state regulator (7/11)
Again, I would challenge that denial and possibly tell a state regulator (7/11)
Step Four: Know Your Billing Codes 
So, there are federal laws that require insurers to cover COVID tests. But if they code your bill wrong - if they use a more generic code for the lab - it won't get covered. I also see this happen a bunch. (8/11)
So, there are federal laws that require insurers to cover COVID tests. But if they code your bill wrong - if they use a more generic code for the lab - it won't get covered. I also see this happen a bunch. (8/11)
These situations are hard because medical bills are very messy! Here's what I would do:
1. Ask for an itemized bill
2. See if they used the right billing code, 87635
If they didn't, I'd likely ask more Qs about what I'm being billed for (9/11)
1. Ask for an itemized bill
2. See if they used the right billing code, 87635
If they didn't, I'd likely ask more Qs about what I'm being billed for (9/11)
I wrote a more detailed guide for the @nytimes today, that has a bit more advice on this topic. (10/11)
You can read it here: https://www.nytimes.com/2020/11/13/upshot/coronavirus-surprise-bills-guide.html
You can read it here: https://www.nytimes.com/2020/11/13/upshot/coronavirus-surprise-bills-guide.html
And if you get a surprise bill? Tell me about it!!!
The only reason I understand how surprise bills happen is from looking at bills patients send me.
We're at nearly 500 bills in our project, and I'd love for you to contribute too: (11/11) http://www.nytimes.com/costofcare
The only reason I understand how surprise bills happen is from looking at bills patients send me.
We're at nearly 500 bills in our project, and I'd love for you to contribute too: (11/11) http://www.nytimes.com/costofcare
