Surprise COVID Test Bills Prompt Complaint to NY Attorney General
Ibrahim Naber, THE CITY. This article was originally published by THE CITY
Free and easily accessible COVID testing for all was more than a political promise — it’s been part of New York’s official strategy from early in the pandemic.
“Get a FREE COVID-19 test and keep your loved ones safe,” Mayor Bill de Blasio tweeted in August 2020.
Meanwhile, Congress also required health insurers to cover most COVID tests, without passing costs on to customers, under the national public health emergency. Many health insurers assured customers all coronavirus testing would be free.
None of that helped Jay Filan, 64, a retired librarian from Brooklyn.
Filan assumed testing was free, after obtaining several tests at pharmacies without having to pay. Then this March, his physician tested positive for the virus, and she asked him to get a PCR test. So Filan went to a testing site in his Bay Ridge neighborhood.
“Everything I heard was that it is covered. They told me nothing about any costs,” he told THE CITY.
Months later, Filan suddenly received a bill over $100. Just a few days ago, an email reached him with a “final reminder“ to pay the bill “before being sent to collections.”
The invoice came from CareCube, a Brooklyn-based physicians group that offers COVID testing at 20 locations stretched across every borough except Staten Island.
In interviews and on social media, THE CITY has identified dozens of customers like Filan who say they feel deceived after receiving bills in connection with coronavirus tests they’d sought at CareCube.
CareCube is defending charging customers for COVID tests, even for patients whose insurance plans provide coverage, saying it is obligated to conduct a “pre-test assessment...to ensure the patient is fit for testing” before inserting a swab.
After receiving multiple complaints from constituents, city Councilmember Brad Lander (D-Brooklyn), a candidate for city comptroller, sent a letter earlier this month to state Attorney General Letitia James calling for a probe.
“We request the attorney general thoroughly investigate CareCube’s practices to ensure that they cannot mislead the public, overcharge, and create unnecessary barriers for COVID-19 testing during a global health crisis,” he wrote.
‘Office Visit’
In Filan’s case, CareCube split his bill into an “office visit,” in addition to the costs for the PCR test itself.
What exactly he was supposed to pay $100 for is not clear from the company’s bill. It only says: “Since your insurance denied our claim therefore we were unable to get reimburse [sic] from your insurance.”
Filan said his insurance company, Emblem Health, told him twice via phone that CareCube had put in an incorrect code on the bill. According to documents, the outfit submitted bills to the insurance company for $325 in total.
Filan’s request by e-mail to re-invoice with the correct code went unanswered by CareCube for weeks — until THE CITY inquired about complaints of incorrect coding.
On Aug. 14, two days after CareCube received a list of questions from THE CITY, the retired librarian got another email from CareCube. It informed him his bill had been cancelled.
Regarding the conflict over billing codes, CareCube said in a statement that the company is “aware of these statements and we are currently working closely with multiple insurance companies.” It also claimed insurers “incorrectly denied claims issued on the patients behalf for this reason.”
Emblem Health did not respond to an emailed inquiry from THE CITY. On its website, Emblem states it covers the cost of diagnostic tests and in-person visit in the case of in-network doctors. At least some of the insurer’s plans would not cover out-of-network services.
But in its statement to THE CITY, CareCube stood by its separate charge for an office visit — and declared it medically necessary.
“As a private healthcare facility, before any medical tests are administered, we perform a pre-test assessment recognized as an office visit to ensure the patient is fit for testing and determine if the test is advisable from a medical perspective,” the statement said.
“This is a basic standard of care required in medical practice. Patients may not recognize that this is considered an office visit by insurers and practitioners because it is different from their typical visit, but laws and regulations make clear that this medical assessment is billable as an office visit.
“Failing to perform this basic function before administering any medical test, and especially any invasive test could constitute medical neglect or malpractice.”
Covered but Still Charged
Multiple CareCube customers complained they were charged copays for taking COVID tests even though their insurance clearly said testing was 100% covered.
James Ellison Jr. also took a PCR test in March with two acquaintances at a CareCube site in Brooklyn, on Seventh Avenue. With a guest coming to visit, they wanted to play it safe. “We had gone to CareCube several times and were not charged,” Ellison said.
But on this visit, he said, “They asked for a copay for the first time.” Even though his insurer, Cigna, covers COVID tests, he was charged $40 on site. So were his friends.
“I talked to Cigna and they told me that I should not copay. Collecting a copay is overbilling.”
“We believe our charges are fair and comparable to other providers,” CareCube said in its statement.
According to Ellison, a Cigna representative told him the insurance firm is among the carriers that agreed to waive all out-of-pocket expenses for COVID-19 testing.
Cigna stated that it is “unable to share specific details about this individuals [sic] claim because of health privacy laws.” But broadly speaking, Cigna said it would continue to pay for diagnostic tests for COVID-19 “performed by a provider within or outside the network without cost-sharing by the customer.”
Ellison said he tried to take CareCube to task personally. He went to two different locations in the city but could find no managers to talk to. He said has not received his money back.
‘Very Frustrated’
Also still hoping to get his money back is Ronnie Almonte, a 32-year-old public school teacher from Brooklyn. In November, he needed a rapid test because he wanted to visit his grandmother in Queens
— their first visit since the pandemic had started. His grandfather had died of COVID months earlier.
Almonte also thought that testing was free. But when he entered the CareCube facility in southern Brooklyn they told him and his partner to pay $125 each.
“I paid for it after waiting outside and I was very frustrated,” he said. “I saw no price on the CareCube website, nothing about costs mentioned.”
An archived page from CareCube’s website from January, a couple of months after Almonte’s test, includes an FAQ assuring customers that insurance will cover tests: “Yes! CareCube accepts most insurances for COVID-19 testing as per CDC guidelines.”
Today, the website says that only unvaccinated people get free testing — and even then only if showing symptoms or “directly exposed to confirmed COVID positive cases.”
Asymptomatic testing is subject to “copay and deductible costs,” it continues.
Said CareCube in its statement to THE CITY: “We have had feedback about persons being unable to understand charges and billing policies which is why our wording has become more detailed.”
Almonte said he managed to pay the testing bills, even though he also had to pay for the grandfather’s funeral expenses at the time.
“How many people get ripped off?” he asked. “Aren’t we suffering enough?”
$1,166.27 in Charges
Some customers have seen multiple bills pile up in their accounts.
Kathryn Yee, a graduate student from Brooklyn, took two PCR tests at CareCube, one in December 2020 and the other the next month.
When she looked at her insurance company’s account, she was shocked. She saw several listed claims related to the PCR tests, ranging from $30 to $642 for doctor’s office visits and medical services. Only some of the claims were covered, according to the insurance company’s documents.
Her account still shows $1,161.27 in unresolved billings.
“These bills just kept coming in and I called CareCube and I was like, ‘What are all these charges?’” she said. CareCube told her to talk to her insurance, United Health Care.
“They told me if I want to dispute these claims I have to talk to CareCube.”
When Yee called CareCube, she said she was told she could send an email. “They were not helpful at all,” she said. CareCube informed her that her insurance “was charged based on the codes billed for all services rendered,” she said.
Yee said she’s very stressed by the back-and-forth: “It’s pretty annoying.”
A United Health Care spokesperson said the insurer is looking into the situation.
The spokesperson noted that members who get an FDA-authorized PCR test for COVID-19 “have zero dollar cost share through the National Public Health Emergency,” adding that if a member believes they have been inappropriately charged for a PCR test they should contact the insurer immediately.
‘I Want a Refund’
Some customers have declared victory in fights against CareCube.
Kierin Baldwin from Brooklyn visited a CareCube testing site last November. She had slight COVID-19 symptoms. And since her son goes to a pre-school, she wanted to play it safe and agreed to pay $125 out-of-pocket for the rapid test.
Rapid test results are typically available within an hour. But she still hadn’t got her results by the next morning. “I called them again at this point and said, ‘I paid for this and I want a refund.’ They told me that they will message the manager and get back to me,” Baldwin said.
She talked to many people on the phone in the following days, and filled out an online form, but didn’t get her money back. It took 26 hours to get her “rapid test” result.
“Two months later, I finally got a response from CareCube which was hilarious,” she said. “They told me that I was not proactive enough.”
At some point, Baldwin decided to try to get the money back on her own. She called her credit card company and explained what happened. “They did an investigation and they refunded the money back to my account,” she said.
Baldwin plans to do without CareCube for COVID tests in the future. “They just try to make a lot of money out of this pandemic,” she said.
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