The cost of a COVID-19 test is all over the map — here’s what to know before you go

Investigations

AUSTIN (KXAN) — So you need or want to get a COVID-19 test: where do you go?

The decision can be overwhelming, and even more confusing is how much it’s going to cost you — despite the fact that major insurance companies say they’re covering it.

But what if you don’t have insurance? What will you be charged?

KXAN posed the question to viewers and its own employees:

What have you paid for a COVID-19 test and where did you go?

Dozens of people responded via email or social media, and the answers were all over the map. Some in central Texas paid nothing while others paid as much as $249 out-of-pocket without insurance.

And then, there were unusual cases like Pam LeBlanc who said her insurance was billed more than $6,000 after she had a swab test done at one of Austin Emergency Center’s drive thru clinics. Another viewer saw the story and reached out saying his insurance was also billed that much, and in the end he was still charged for more than $2,000 of it.

KXAN learned Thursday that these patients were billed for lab work that was never done, and the problem is being corrected.

If you’re looking for a free test, here’s what you need to know: Every single person — with or without insurance — who went to a CommunityCare clinic, CVS Pharmacy or an Austin Public Health testing site said they did not have to pay a dime. Testing was completely free at these locations, because the programs are all government funded.

Austin Emergency Center

KXAN had an at-length conversation with Austin Emergency Center because three viewers reached out about receiving exorbitant insurance bills after visiting their drive thru COVID-19 clinics.

In at least two cases, patients told KXAN their insurance was billed over $6,000 for their trip to get a swab test at the AEC clinic in the Mueller neighborhood on East 51st Street.

Viewers who did not use insurance and paid out-of-pocket said they were charged $249 at the same drive-thru.

AEC, which has four locations in Austin, said it operates just like an emergency room attached to a hospital. The only difference is its free standing.

When the pandemic hit, AEC doctors and leaders developed a process to evaluate a patient outside in their cars. Unlike the mobile clinics that are government funded and offering free testing, AEC said it is still assessing patients in the drive thru like they would if that patient were to come into the building.

AEC said it felt like the assessment portion was important for patients so they can have their concerns addressed, and be brought into the building if they appeared to be ill and needed treatment.

With the assessment, comes two separate fees:

  • Professional fee — covers assessment, patient evaluation, treatment plan discussion
  • Facility fee — covers basic costs needed to stay open 24 hours a day (ex: water and electricity)

AEC bills the insurance company for the two fees, and said insurance companies typically pay 40% to 80% of the two fees. However, the major insurance companies have said during the current crisis, they’re paying for all COVID testing and all COVID-related costs — which is supposed to include emergency room expenses.

The outrageous insurance bills can be traced back to Genesis Lab, according to AEC.

The center decided to start using the lab after an extensive search because Genesis was able to provide a large quantity of test kits, and fast results in two days. One difference with Genesis, according to AEC, is that the lab bills the patient’s insurance directly, where in most cases the lab bills the provider and the provider bills the insurance company.

When AEC learned on June 2 Genesis was charging patients fees in the thousands, and in some cases thousands of dollars in fees for lab work that was never even done (like in Pam LeBlanc’s case), they put a stop to it.

AEC said from that point forward Genesis stopped billing insurance directly, and AEC started going to bat for patients dealing with high bills so that they will not be on the hook for those charges.

KXAN was also told some patients not using insurance paid AEC $249 for one COVID-19 test they received in the drive thru, while others paid $199.

AEC said it adjusted the price from $199 to $249 due to the rising cost of supplies. The $249 fee is the cash price AEC came up with that covers the testing, but waives the professional and facility fee.

When it comes to patients on Medicare and Medicaid, AEC said free standing ERs do not get reimbursed for either, therefore they become cash pay patients.

In a statement on Thursday, AEC said, in part:

AEC is an emergency room operation that offers COVID-19 symptom assessment and testing. All patients have their history and vitals taken, and are evaluated by a nurse and emergency room provider. If they are critically ill, they are brought inside the emergency room for further evaluation.

Our company is not affiliated with Genesis Labs. When we learned of the exorbitant fees they were charging for their lab test, we immediately sought out a new lab to partner with. For those patients who were charged these outrageous prices for their testing, AEC will work on their behalf to do everything we can to make sure they don’t have a patient responsibility balance due.

Those with billing concerns should call the AEC Patient Advocate Line at (512) 736-7097.

Copyright 2020 Nexstar Broadcasting, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

Austin-Travis County

More Austin-Travis County News

More Investigations

More Investigations

Latest Central Texas COVID-19 Cases

More Coronavirus Live Blogs

Trending Stories

Don't Miss