It sounds like the most awful healthcare joke of all: They went to the hospital for Covid testing, gave their insurance information, and were turned away with no treatment. And yet! They got billed!
It happened to Rebecca Oliver and Dan Loncoa of Irondequoit, N.Y., at Rochester Regional Hospital.
“I had traveled out of state and upon returning thought it would be a good idea to get a covid test,” Oliver, a teacher, who turns 29 years old on Wednesday, told us by email. “Cuomo claims ‘all New Yorkers can get tested for free’ so I showed up to the closest drive up testing location near my house which happens to be a hospital on 7/8/20. I waited in my car for an hour and in that time they took my information (and insurance). When I got to the front my only complaint was a sore throat. The people told me that they were short on tests and our complaints weren’t enough of an issue to get tested (the state we had visited was not yet on the quarantine list). They then told us that Cuomo’s statements (of anyone can get a test for any reason) were in reference to a single testing location at the local community college and gave us the phone number to make an appointment there.
“Two weeks later I got a bill for $252 for an emergency room visit. My boyfriend who has different insurance than me got a bill for $540. We never even left my car.”
She said she called both the hospital and insurance company to appeal, and so did Loncoa, 30, who works in information technology. He was told that his bill was higher because the hospital is out of network for him on his Aetna insurance policy, while her bill was the in-network emergency room charge for her insurance company, Excellus, which does have Rochester Regional in network.
“At this point I have checked in with the hospital and my insurance company multiple times as the first person told me to check in every few weeks. However, recently when I called the hospital the person was very agitated with me and essentially hung up on me telling me it was my insurance’s issue not theirs. My insurance then told me that filing an appeal was the incorrect thing to do (even though that’s what’ their earlier rep told me to do) and that I would need to file a grievance instead. Apparently these processes take 30-45 days to complete. I was nervous about this as the bill stated it was due early August – but they told me the bill would be on hold until they had come to a conclusion but the outlook didn’t look great for me.
“I don’t understand why I am being billed when we were turned away. It would make sense and I would be more willing, although I would still be annoyed, if we had received care.”
One bill went away, but one did not
Oliver and Loncoa both sent us copies of their bills, and a note as a HIPAA waiver so we could talk about their questions. We reached out to both the hospital and their insurance companies for comment.
After several exchanges of emails, we got this note from Ethan Slavin, the media contact at Aetna, to both me and Loncoa, saying that Loncoa’s bill had essentially been wiped away.
“Our service team was able to work with Rochester General Hospital on this matter yesterday. Dan – I believe that a member of our service team left you a message, but we were able to resolve the matter so that you don’t have any cost sharing for your situation. I would call the number that they provided if you have any additional questions, but wanted to make sure that information had been relayed to you.”
At Excellus though, it was more complicated. This is what we heard from Jim Redmond in media relations at Excellus. First he told us that Excellus would not comment on a specific case. When we asked again, he sent this email.
“Again, we don’t comment on the specifics of an individual case.
“Generally, it would appear that the issue is with a hospital charging for services not rendered. Consumers have rights of appeal in New York state and we always encourage consumers to take advantage of those rights. In a case similar to this one, the first call would be to the hospital that issued the bill.
“Please note that free COVID-19 testing is available at locations across the state operated by the New York State Department of Health. Individuals do not need to be symptomatic or essential workers to obtain a test from these state sites. For more information, can call the health department’s 24-hour hotline at (888) 364-3065.”
At Rochester Regional Hospital, it was still more complicated. We sent a query to Veronica R. Chiesi Brown,
the public information officer, asking for comment, on Sept. 8. We didn’t hear back, so we emailed her again on Sept. 9, with the same query. She responded, “We received your inquiry. Thank you.” We mentioned that we were planning to post the story, even if the hospital had no response.
We asked again on Monday, Sept. 14, and she replied, “We are in the process of reviewing the complaints you sent to us.”
See our other coverage of coronavirus testing here.
Jeanne Pinder is the founder and CEO of ClearHealthCosts. She worked at The New York Times for almost 25 years as a reporter, editor and human resources executive, then volunteered for a buyout and founded ClearHealthCosts.
She was previously a fellow at the Tow Center for Digital Journalism at the Columbia University School of Journalism. ClearHealthCosts has won grants from the Tow-Knight Center for Entrepreneurial Journalism at the Craig Newmark Graduate School of Journalism at the City University of New York; the International Women’s Media Foundation; the John S. and James L. Knight Foundation with KQED public radio in San Francisco and KPCC in Los Angeles; the Lenfest Foundation in Philadelphia for a partnership with The Philadelphia Inquirer; and the New York State Health Foundation for a partnership with WNYC public radio/Gothamist in New York; and other honors.
Her TED talk about fixing health costs has surpassed 2 million views.