Date: 2024-10-19 Page is: DBtxt003.php txt00018446
US Healthcare
A dangerously broken system
HEALTH CARE ... THE COST OF NOT GETTING TESTED FOR CORONAVIRUS: A $10K ER BILL
The US health system is an embarrassment. More than 50 years ago I was a very young CFO and very effective because of some training I had had in cost accounting. Fast forward, we need some radical transparency about how much everything actually costs in the health system and where the abuses are located and who is responsible. Many procedures do not cost very much, but the price being charged makes them obscenely profitable ... and of course very few patients have any role in the price setting process. It is a disgrace. PeterB #TVM
Peter Burgess
NYU Langone Health in Cobble Hill, Brooklyn, March 10, 2020. Photo: Ben Fractenberg/THE CITY
First Brooklyn public school teacher Erin McCarthy began experiencing potential coronavirus symptoms after returning from Italy.
Then a doctor — wearing a hazmat suit — told her she couldn’t be tested because she didn’t fit the criteria at the time.
But that wasn’t her last shock: She recently got a bill saying her fruitless March 2 ER visit cost $10,382.96.
“And I wasn’t even tested,” McCarthy said.
McCarthy is lucky: She has insurance coverage and will only have to cough up a $75 co-pay for her visit to The NYU Langone Health–Cobble Hill emergency department. Her insurance company will pay a negotiated-down rate.
“But imagine if I didn’t have insurance,” McCarthy said, recounting a time when she was uninsured and wound up paying off an ambulance bill for years after she needed transport following a fall.
By noon Tuesday, 36 people in New York City had tested positive for COVID-19, a spike over 20 the previous day. Another 195 tests were pending, 30 individuals were in mandatory quarantine and 1,980 were in voluntary isolation, Mayor Bill de Blasio revealed during this now daily press briefing on the global pandemic.
The mayor emphasized that the city is not testing anyone unless they display symptoms.
Sent Home
When she sought the virus test, McCarthy, 44, a veteran teacher at PS 369 in Brooklyn, was suffering from fever, headaches and tightness in her chest. And she’d just returned from a week in regions of Italy where the virus was spreading.
So on March 2, she went to the emergency room at NYU-Langone in Cobble Hill, hoping to be tested. She says she spent about six hours there, mostly waiting, spoke with a doctor for about 20 minutes, and got a chest X-ray.
The doctor told her she was not eligible for testing because, while she was displaying potential COVID-19 symptoms, she was not elderly and did not have immune system issues.
Teacher Erin McCarthy during her February trip to Italy. Photo: Courtesy of Erin McCarthy
Her visit to Italy also didn’t count as a factor because, at the time, the country was not on the city’s official list of hot zones that would require a test. It is now.
McCarthy was sent home with a letter stating that she needed to self-quarantine until there was a “complete resolution” of the symptoms. After THE CITY reported on her case, city Health Commissioner Oxiris Barbot issued an order greatly expanding the categories that would trigger testing for public school educators, first responders and city health care workers.
A few days after her ER visit, McCarthy got the bill from the hospital stating the hospital billed $10,382, her insurance plan paid $2,957 and that she owed a $75 co-pay.
A Negotiated Fee
On Tuesday, THE CITY requested an explanation from NYU Langone for the bill. In response hospital management released a statement:
“Billing for hospital services is different for each patient, for each provider and each insurer, depending on what the patient is being seen for and what services were provided by the hospital. In addition, there are different parts to a patient bill. One part is what the hospital charges the insurance company, one part is what the insurance company eventually pays, and the last part is what the patient owes for the services, or the patient co-pay.“The bill in question charged the insurer a fee, the insurer paid a negotiated percentage of that fee — and the patient owed only a co-pay of $75.00.”
Meanwhile, Vice President Mike Pence — put in charge of the federal government’s response to the coronavirus — announced Tuesday that major insurance companies had agreed to waive all co-pays for COVID-19 tests and extend coverage for coronavirus.
A screen shot of bill emailed to McCarthy for time spent at NYU Langone. Photo: Courtesy Erin McCarthy
After the city health commissioner’s order changing the protocol for testing was issued March 5, McCarthy was able to get an actual test. The results turned up negative for coronavirus.
As of Tuesday, she had yet to receive a bill for that test, which took place at New York-Presbyterian Brooklyn Methodist Hospital in Park Slope. She said the hospital did not request her insurance information, so she doesn’t expect she’ll be getting a bill.
THE CITY asked the Health & Hospitals Corporation, which runs the city’s 11 hospitals, how much the system will be charging patients for a coronavirus test. A spokesperson for the agency did not respond to the question.
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Jerry AshtonStatus is online Jerry Ashton • 1st Co-Founder of RIP Medical Debt and Director/Outreach and Engagement. Co-Author of 'End Medical Debt.' 1h • 1 hour ago
THE COST OF NOT GETTING TESTED FOR CORONAVIRUS: A $10,000 ER BILL
Teacher Erin McCarthy on March 2, went to the emergency room at NYU-Langone in Cobble Hill, hoping to be tested. She says she spent about six hours there, mostly waiting, spoke with a doctor for about 20 minutes, and got a chest X-ray.
The doctor told her she was not eligible for testing because, while she was displaying potential COVID-19 symptoms, she was not elderly and did not have immune system issues. (More at link) No alt text provided for this image
The Cost of Not Getting Tested for Coronavirus: a $10K ER Bill
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