One doctor in Austin literally got a taste of his own medicine after going to his own practice to get a Covid antibody test. Assuming he would get one for free because he worked for the company, his insurance instead wound up getting a bill from Physicians Premier ER for $10,984. His insurance paid it all.
But the doctor in question, Dr. Zachary Sussman, became so dismayed, he quit his job, according to ProPublica. Now, the parent company of Sussman’s insurer is investigating the case.
Sussman was working part time at four Physicians Premier ER centers, making $4,000 per month to oversee antibody testing. The job was a temporary gig between permanent jobs in Austin and New Mexico.
He decided he wanted to take his own test in May, before visiting his family, because he had developed a headache. He went to his own company for a test and, knowing “the materials for each antibody test only amounted to about $8, and it gets read on the spot ” – and that he could even administer the test, figured costs would be minimal.
He said he had a quick talk with the ER doctor and there was no physical exam. After 30 minutes, he tested negative. He received his EOB in the mail about a month later showing the charges came to $2,100. “It may as well say Gucci on the outside,” he said about the ER.
Several weeks later, a second EOB arrived for the Physicians Premier facility charges – these amounted to $8,884.16. He said he felt “spooked” after seeing the bill and realizing his employer had charged his health plan a total of $10,984.16 for the 30 minute visit.
He tendered his resignation weeks later, stating: “I have decided I can no longer ethically provide Medical directorship services to the company. If not outright fraudulent, these charges are at least exorbitant and seek to take advantage of payers in the midst of the COVID19 pandemic.”
USA Emergency centers responded, telling ProPublica: “The allegations are false. The company takes all complaints seriously and will continue to work directly with patients to resolve issues pertaining to their emergency room care or bill. …The allegations received pertain to a former contracted employee, and we cannot provide details or further comment at this time.”
Shelley Safian, a Florida health care coding expert, called the charges “obscene” and said: “This is the exact opposite of an employee discount. Obviously nobody is minding the store.”
Maria Gordon-Shydlo, a spokeswoman for UnitedHealthcare, which owns Sussman’s insurer, Golden Rule, said: “Golden Rule has put processes in place to address excessive COVID-related billing. We are currently investigating this matter and, if appropriate, will seek to recoup any overpayment and potentially refer this case to law enforcement.”
And this isn’t the first time price gouging of this nature has taken place related to Covid tests. ProPublica had previously pointed out that $175 Covid tests were resulting in charges of $2,479 at another ER in Texas. Even though the price was reduced due to insurance in that case, the charges still must be paid from those who are shelling out for insurance premiums.
You can read the full ProPublica article here.