Covid leaves some with medical bills, job insecurity, lingering isssues

Welcome to the Covid Economy, CNBC Make It’s deep dive into how the coronavirus pandemic is impacting all areas of our lives, from food to housing, health care to small business. We’re focusing on North Carolina, a swing state that has seen rapid economic growth — and growing inequality — since the last recession to learn how residents are weathering the economic consequences of this once-in-a-lifetime health crisis.

Ann only let her guard down for an afternoon. After months of being careful and following social distancing guidelines, she got together with a friend over the Fourth of July weekend. The next day, that friend let her know they were feeling sick. Four days after that, Ann began developing symptoms, too. 

An HR manager based in the Charlotte, North Carolina, area, Ann, who agreed to speak to CNBC Make It on the condition that she be identified only by her middle name to protect her privacy, scheduled a Covid-19 test on July 15. She received a positive result two days later. 

It’s been more than four months, and Ann’s still struggling to fully recover from the virus. But it’s not just her health that’s been impacted. She’s had to take an unpaid leave of absence from work, and despite having health insurance, she’s worried about the mounting medical bills.

During the nearly three weeks that Ann suffered from the worst effects of Covid-19, she was mainly isolated at home. “There was an entire week that I had to lie on my stomach for hours just to breathe without a crushing pain in my chest,” Ann says. “The vomiting and diarrhea were so unyielding that one day I contemplated just sitting in the tub instead of going back and forth to the toilet.”

At one point, Ann’s symptoms were so serious, she did go to the emergency room. Fortunately, her hospital stay was short, and she never had to be put on a ventilator. But even after the worst of her symptoms passed, her life has yet to return to normal. One of the rising number of so-called “long haulers,” Ann is still feeling the ongoing effects of the virus. 

“It’s just so weird to me to be someone who is healthy and in their thirties to have something just completely ravage you so hard that it affects every organ in your body,” Ann says. 

Costs of Covid-19 vary dramatically and can go beyond just medical bills

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Insured Patients Are Getting Surprise Bills After Colonoscopies | Health News

By Amy Norton
HealthDay Reporter

(HealthDay)

FRIDAY, Oct. 16, 2020 (HealthDay News) — Many Americans who get recommended colon cancer screening may end up with “surprise” medical bills, a new study suggests.

Looking at insurance claims for more than 1.1 million elective colonoscopies, researchers found that 12% involved out-of-network charges.

That’s concerning, the study authors said, because those patients may well have faced bills averaging $400 for a procedure they thought was covered.

The issue has received much media attention of late. Surprise billing happens when insured people receive treatment from a provider in their health plan’s contracted network, but someone on the medical team is not in-network.

The insurance plan may pay part of that provider’s charges, but generally not all. So the patient often ends up with an unexpected bill for the rest.

Often, surprise bills are related to elective surgery — a situation in which patients pick their surgeon and hospital but have no choice about other providers involved in their care. Those providers, such as assistant surgeons, anesthesiologists and radiologists, may be out-of-network, the researchers explained.

But the new study shows the problem extends to screening colonoscopy, a recommended way to catch colon cancer early.

“We want to bring attention to this,” said lead researcher Dr. James Scheiman, chief of gastroenterology at University of Virginia Health in Charlottesville. “There really has been no assessment of the scope of the problem.”

The concern is that some folks will be deterred from getting colon cancer screening, he said.

Experts recommend that people at average risk of colon cancer begin screening at age 45 or 50. That can be done various ways, and a colonoscopy every 10 years is one option. During the procedure, the doctor can not only detect cancer, but also remove any pre-cancerous growths.

“We know it works,” Scheiman said. “We can’t let out-of-pocket costs keep people from this potentially life-saving screening.”

The findings — published online Oct. 12 in Annals of Internal Medicine — are based on claims from a large national health insurance plan. Scheiman’s team focused on more than 1.1 million elective colonoscopies where the facility and the doctor performing the procedure were in the health plan’s network.

Despite that, one in eight claims included out-of-network charges. That translated to nearly 136,000 colonoscopies for which patients potentially received a surprise bill. (There was no way to determine how many patients actually did, Scheiman said.)

Those out-of-network charges were typically around $1,000. Accounting for the portion the insurer would likely pay, the researchers estimated that the typical surprise bill would be about $400.

Overall, anesthesiologists and pathologists (doctors who study tissue samples) accounted for most out-of-network charges, the investigators found.

And that’s no surprise, said Loren Adler, associate director of the USC-Brookings Schaeffer Initiative for Health Policy, in Washington, D.C.

In general, Adler said, surprise bills come from a limited number of specialties — the providers patients do not choose. Emergency room doctors, anesthesiologists, radiologists and pathologists — as well as ambulance services —

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