COMPLAINT FILED AFTER $1,567 BILL FOR COVID-19 TEST & RELATED ITEMS
After Germantown woman appeals, Baptist waives her fee
It was March 20, 2020, the early days of the COVID-19 pandemic in Memphis, and Renee Utley was feeling sick. She says her symptoms included a sore throat and headache, and she worried that she
might have contracted the new virus.
She traveled to one of the few sites in the area that was then offering a COVID-19 test, Baptist Memorial Hospital-memphis on Walnut Grove. Her negative test result came a few days later. Then came a letter telling her the visit had cost $1,567.
Her health insurance had paid $406. That left about $1,161 for her to pay.
“I was mad. Furious. Because I know that that’s not right,” she said.
In this case, the hospital billed Utley not just for the COVID-19 test, but a battery of tests for flu and other illnesses, and also charged her for an emergency room visit, even though she says she never entered the emergency room, but rather walked into a tent in a hospital parking lot.
She refused to pay the bill and in February filed a price-gouging complaint to the Division of Consumer Affairs, an arm of the Tennessee attorney general’s office. A collection agency began demanding the money.
Following inquiries from the state office and from The Commercial Appeal, a Baptist spokesperson, Ayoka Pond, said Thursday that the hospital had changed course. “We waived her bill. She’s not responsible for paying any of that bill and she actually received the bill in error.”
Congress had passed a law in March 2020 that requires insurance companies to cover COVID-19 tests as well as to cover tests to rule out other diseases, like influenza. Insurers are not supposed to pass along costs to patients.
That bill was signed into law only days before Utley took her test at Baptist.
“Ms. Utley received this bill in error in part because her insurance company did not pay the bill in full like the federal government required insurance companies to do for Covid-related testing,” Pond wrote in an email. “We regret any inconvenience this has caused. We do not intend to bill patients for COVID testing.”
She also said that at the time Utley took the test, the hospital treated COVID-19 test encounters in the parking lot as emergency room visits. The hospital changed this practice later in March 2020 and no longer bills them as emergency room visits, she said.
It is unclear how many other people received similarly large bills from Baptist for COVID-19 tests. At least one other person filed a state complaint over a Baptist bill for COVID-19 tests. Baptist says that bill was also in error and that the hospital waived it months ago.
She could afford it — but saw bill as wrong
Utley and her husband run a real estate business and live in a large home in Germantown.
In an interview before Baptist said it was waiving the bill, Utley, 63, said she could afford to pay the extra money for the test.
“But the point is, a lot of people could not. And if they thought they were gonna have to pay anything like this to get a test, they’d never go. I wouldn’t have gone to Baptist if I thought they were going to charge me $1,500.”
And she said that could damage public health. “The whole point to try to get through this whole pandemic is to test and quarantine,” she said.
Utley said since that first test in March 2020, she has been tested many times and never required to pay anything out of pocket.
Utley said she called Baptist’s collections department more than once and discussed the cost. She recalled a staffer asking her, “‘Well, what would you offer to pay for it?’ I said, ‘Well, my insurance has paid $406.28. I would say that would be payment in full. That’s what I will offer as my payment.’”
She said she didn’t hear back, and filed a complaint with the Tennessee consumer protection agency on Feb. 24.
The standard price of a COVID-19 test is usually around $100, said Sabrina Corlette, a research professor at the Center on Health Insurance Reforms at Georgetown University.
Early in the pandemic, medical providers routinely ran a battery of other tests to rule out the possibility that a patient’s illness was another virus other than COVID-19, she said.
But she said Baptist’s decision to bill the test encounter as an emergency room visit seemed like price-gouging.
Pond, the Baptist spokesperson, said at the time, people who showed up at the tent received not just a test, but a medical examination.
Utley signed a release form that allows Baptist to discuss her case. The hospital released visit records that say she arrived at 11:20 a.m., was listed as admitted at noon, and discharged more than three hours later, at 2:46 p.m. The records also say medical professionals asked her about her symptoms and took vital signs including temperature and pulse.
Utley says she remembers someone taking her temperature and says someone may have asked about symptoms, but she doesn’t recall other steps of a medical exam.
She also said she spent only about five minutes in the tent. “I was in my car most of the time, waiting to be called, just like everybody else,” she said.
The Commercial Appeal contacted the Georgetown professor again Friday to discuss the new timeline information the hospital had released. “When we talked before, I thought that she literally walked up to a tent, had somebody stick a swab up her nose and that was it,” Corlette said.
“But if there was more services delivered, then those charges don’t sound quite so excessive. They’re still high and probably higher than they should be, but it’s probably on par with what the hospital is charging private carriers in general.”
A change in policy — March 30, 2020
On March 30, 2020, Baptist began treating the COVID-19 testing tent as an extension of its medical group, rather than its emergency room, and patients were no longer billed for an emergency room visit, Pond said. A waiver from the Centers for Medicare & Medicaid Services made the switch possible.
Baptist is a regional nonprofit hospital and medical group with its headquarters in Memphis and operations in Tennessee, Mississippi and Arkansas. To date, the system has performed more than 670,000 COVID-19 tests, Pond said.
Only a small proportion of people early in the pandemic were billed as Utley was, she said. “This is a very rare occurrence.” She said she didn’t have the precise number.
The state consumer affairs offices in Arkansas and Mississippi said they didn’t have similar complaints involving Baptist.
The Division of Consumer Affairs in Tennessee has received a total of five complaints about COVID-19 tests, including three in middle and east Tennessee. The two complaints in West Tennessee both involve Baptist, spokeswoman Samantha Fisher wrote in an email.
One complaint is from Utley. The other complaint was filed by a Memphis woman who said she and her husband went to the Baptist hospital on Walnut Grove on May 23, 2020, for what she thought was a free test.
“My bill was $190, and my husband’s was also $190, making it a total of $380 for our
household,” the woman wrote on the complaint form. “The original cost w/o insurance was $600 & I don’t think my insurance should have been billed to begin with.”
The state agency marks the other complaint against Baptist as closed. A note on that case says, “(Baptist) responded and indicated they would respond directly to Complainant due to HIPPA, but that they never advertised themselves as a free testing site.”
Pond, the Baptist spokesperson, said the hospital had billed the patient in error and had already corrected the issue. “We waived this bill last July because we did not intend to charge the patient for COVID testing. They received a bill in error because their insurance company refused to pay it in full.”
The national picture
Overbilling cases related to COVID-19 tests have been reported around the country. In some cases, test providers have worked to obtain large fees from insurers, rather than patients.
At Lenox Hill Hospital in Manhattan, for instance, a big banner advertised COVID-19 testing. The hospital repeatedly billed patients more than $3,000 for the test by counting it as an emergency room visit and by billing a high price for the test itself, The New York Times reported.
That cost was passed along to the patients’ insurance companies — who in turn can be expected to pass it along to their customers in the form of higher insurance premiums. This practice was active into 2021, The Times reported. Kaiser Health News this month released a report that says some hospitals and other providers are profiting from COVID-19 tests by charging insurers more for the tests than they cost to perform.
Pond, the Baptist spokesperson, said Medicare and other insurance companies that work with the hospital pay about $100 per COVID test. Once the cost of personnel are factored in, that’s less than it costs to administer the tests, she said.
Resolution
On Wednesday, Utley said a person from Baptist had called her and told her the hospital intended to waive her bill and collect from her insurance company instead.
She said she still wants to clear the issue with the collection agency and avoid damage to her credit.
She said she believes Baptist is overcharging insurance, too. “It all comes back to the consumer.”
Still, she said she was pleased with the outcome.
“It’s wonderful. I appreciate them giving me a break,” she said.
She recalled the long line of vehicles waiting for a test on that day back in March 2020. “I hope that everybody else in line didn’t get charged for it.”
Baptist is asking anyone who has received a bill for a COVID-19 test to contact the billing department at 800-4-BAPTIST, or 1-800-4-2278478.
This story began with a reader tip. Send your tips on medical bills or anything else to investigative reporter Daniel Connolly by calling 901-529-5296, emailing daniel.connolly@commercialappeal.com, or on Twitter at @danielconnolly.