JACKSONVILLE, Fla. — The COVID-19 test is uncomfortable but necessary during this pandemic. Until now very few questioned its cost.
"I used to be a claims adjuster back in the day so I said 'Let me look at it,'" said Karla.
Karla, whose husband asked us not to use their last names for security reasons, is now raising questions about an insurance Explanation of Benefits statement revealing the price of her son's COVID-19 tests.
"Why does it cost $3,100?" she asked.
Karla's son is a student at the University of Central Florida.
He was tested January as part of their move-in policy. It was done by a school-approved service provider, which the college has used since April 2020.
There is no cost to the students, but if there's health insurance, insurance is billed.
In this case insurance was billed $3,100 for one test, per the EOB statement.
"He just went back this past week and had another test done, and it has to be done down there from what we understand," Karla explained.
Karla said her son has been tested three times since the school year began.
"I am just saying $9,000 for three COVID tests, that is ridiculous," she said.
A company representative told First Coast News they offer many different services that justify what they bill insurance:
"We are the provider on site who is swabbing patients, we provide the covid kits and PPP, we provide the courier service back and forth from test site to our lab, we offer the consult service with a Nurse Practitioner if requested, and of course, we are the laboratory who conducts the specimen analysis and then provides results via online/email. So, we are not like an urgent care or CVS where we just swab then farm out the sample to a lab who then bills the patient’s insurance at a later time for their service. We provide several service lines that justify our billing to insurance.
"As you also know, we very rarely get paid 100% on our bills from insurance. Majority of the time it is just a fraction of our bill that insurance pays.
"No matter what. So, at the end of the day the patient does not pay anything ever out of pocket for a COVID test."
Even so, Karla is not completely satisfied with the explanation. She finds it hard to believe that the price of COVID-19 testing is $3,100 per exam.
"If we didn't have insurance, then they will bill the state," Karla explained. "So is the state paying $3,000 for each of the test for each one of these children with no health insurance?"
According to one insurance industry expert, the state is paying 100% under the Coronavirus Aid Relief Economic Security (CARES) Act.
First Coast News also reached out to UCF and was told that students now have the option of using other providers:
"Options have since been expanded to include other testing types and providers...It also is important to recognize that what is billed to insurance is not what insurance pays – students may be seen an insurer’s explanation of benefits. An EOB is not a bill."