When you bill an insurance company $2,715 for a COVID-19 test you probably don’t expect Congress to start calling.
But then not everyone’s patient is Carolyn Coburn, the widow of former Oklahoma Senator and renowned waste-fighter the late Dr. Tom Coburn.
Mrs. Coburn went to the Tulsa ER & Hospital for a “scheduled in advance” COVID-19 test. She later saw the $2,715 bill that went to Blue Cross and Blue Shield for her visit. Then, she got another bill, bringing the total visit cost charged to her insurer closer to $4,000.
“Nobody should charge $4,000 to stick a Q-Tip up someone’s nose,” Coburn responded to our request for comment. “I felt Tommy’s fighting spirit,” she added in reference to her late husband. “He was upset about $4 trillion, I could see how he felt.”
Coburn was appalled by the cost and began her foray into the national debate over price transparency.
According to a May 2020 Harvard Harris poll, 88% of Americans support price transparency in health care and 67% feel they are not given enough detail and transparency when it comes to their medical care costs.
But wanting and getting are two different things.
Stephania Grober, vice president of sales and marketing for Blue Cross and Blue Shield of Oklahoma, said Tulsa ER & Hospital and a sister facility in Edmond are “charging for services that are just outrageous and adding significant, unnecessary costs to the system. What’s happening isn’t right,” she told Tulsa World. “It’s taking advantage of this pandemic situation.”
However, the founders of Tulsa ER & Hospital – a micro-hospital – are actual working ER physicians and have a compelling story, too.
A spokesperson confirmed that the centers had price disclosure, posted signs, and required signed patient consent forms since at least the summer of 2020. Responding to our comment request, Dr. Christion Rice – partner, Tulsa ER and Hospital stated:
“As physician-owned ERs and hospitals we operate and follow the same federal and regional legal requirements as health system-owned ERs and hospitals. We benchmark the pricing of services and tests with a third-party, conduct audits to catch and resolve all anomalous billing, and continue to update our practices to ensure our patients have the information they need to make an informed decision as this pandemic evolves.”
The Tulsa facility is not alone in having its COVID pricing questioned, it just happens to have served (and billed) the widow of one of Washington’s most famous waste-cutting doctors.
For example, ProPublica released a report on a doctor in Texas whose insurance company was billed (and paid) $10,984 for his COVID-19 test last May: a test done at the hospital where he worked.
Carolyn Coburn didn’t really know the going rate for a COVID-19 test, but she was pretty sure $4,000 was too much. And she told the Tulsa World her late husband, U.S. Sen. Tom Coburn (the honorary chairman for OpenTheBooks.com) “fought this kind of thing all the time[.]”
Tulsa ER & Hospital says it provides “concierge-level emergency care 24 hours a day, 7 days a week.” In fact, a managing partner at the Oklahoma hospital told Tulsa Worldwhat its website also confirms, “We are not an urgent care…We are an emergency room.”
In fact, a recent review of the Tulsa ER & Hospital website shows it is not advertising for COVID testing.
Furthermore, the local newspaper reports, “A sign on the front desk warns patients they will be charged an emergency room fee for COVID-19 tests unless they have an outpatient order from a doctor, and patients are required to sign a simple one-page document explaining that — although the document says insurers ‘will typically pay a small percentage’ of the charges billed.”
Locals report the in-house lab at Tulsa ER & Hospital was analyzing tests on-site and thus they were able to gain early market share on rapid-results testing.
“Word got out, you could get test results back quickly from the Tulsa ER and many of us needed to have a negative test before returning to work or getting our kids back to school,” one Oklahoma small business owner told Forbes.
Following up on a school nurse’s tip about Tulsa ER’s fast test results, he went for a COVID-19 test and called the place and the process “first class.”
The concierge treatment included meeting him at his car for paperwork and ushering him straight to a room for a physician exam and test, results of which he got back in about an hour. His negative test results enabled him to get back to work and “salvage my team” of employees from additional quarantines.
Seven minutes east at the local Walgreens WBA -0.8% or 10 minutes south at the local CVS, Tulsa patients now can schedule appointments for COVID-testing and get rapid or PCR tests. But Tulsa-area test results weren’t coming back quickly in the fall and some facilities filled their waiting rooms with potentially COVID-positive patients.
Last fall, the health department and local labs reportedly were facing longer delays in reporting testing results. That sentiment was confirmed by the Tulsa ER & Hospital administrator who acknowledged to the Tulsa World many of those coming to it for COVID tests say they did so after deciding the wait for tests and results at other facilities was too long.
Coburn’s insurer was billed $450 for the COVID-19 test itself, the balance of the bill was for her emergency room visit and physician fees. Coburn herself did not pay anything, but that didn’t stop her from writing and calling, and getting her concerns heard in the halls of Congress.
Coburn’s questions reflect the concerns of millions of other Americans who are asking why health care pricing is so opaque, and why our health care system wasn’t nimble enough to make low-cost, rapid COVID-19 testing widely available.
A year into the pandemic, Carolyn Coburn isn’t alone in seeking answers.
Additional Reading
Read the entire response to our request for comment from the Tulsa ER & Hospital, here.
President Donald Trump’s June 24, 2019 Executive Order on medical price transparency.