Dr. Zachary Sussman thought that by getting a COVID-19 antibody test at a facility under the hospital chain he worked for, he might be spared of the expenses. He was wrong.
Physician Premier ER, located in Austin, Texas, billed Sussman’s insurance company $10,984 for his visit, even though Sussman is a doctor for the chain, he said. He quit his job shortly thereafter.
“It may as well say Gucci on the outside,” Sussman said about the facility that has a free-standing ER with no wait, according to ProPublica.
The 44-year-old pathologist had taken a temporary position at four of Physician Premier ER's other facilities overseeing antibody tests. When he began getting headaches in May, shortly before a planned trip to Arizona to visit his family, he wanted to get a COVID-19 test done.
Sussman assumed the test would be comped by Physician Premier ER, but he said the staff took down his insurance details anyway and charged the company the full amount despite doctors never having “laid a hand on me."
His visit was less than 30 minutes long with no physical examination, and the materials for the antibody test only costs about $8, according to ProPublica. The test is read on the spot, like an at-home pregnancy test, ProPublica reported.
Sussman said he is now sharing his story to shed light on the alleged practices in the medical field in the wake of the coronavirus pandemic.
When reached for comment, a spokesperson for UHC told Inside Edition Digital they were unable to comment on the story unless given permission by Sussman. Inside Edition Digital has reached out to Sussman.
The insurance company said in a statement to ProPublica they have “put processes in place to address excessive COVID-related billing. We are currently investigating this matter and, if appropriate, will seek to recoup any overpayment and potentially refer this case to law enforcement."
Physician Premier ER said in a statement to Inside Edition Digital that they are required to bill for every single visit, and each visit is billed as an emergency room visit.
However, "based on our internal review process, we found this to be a single-instance anomaly resulting from a coding error ... We are working to rectify this specific situation via reimbursement. We are dedicated to providing excellence in emergency healthcare to our patients, and will continue to advance our own processes to serve as a responsible partner to our communities and insurance providers," Physician Premier ER said.