Zachary Sussman, MD, went to his employer, Physicians Premier ER, for a COVID-19 antibody test. The company billed and got paid $10,984 for the visit, according to ProPublica.
Dr. Sussman was working under contract with Physicians Premier ER as a part-time medical director in May, when he got a COVID-19 antibody test at one of its freestanding ERs in Texas. Staff assured him that he would not be responsible for any part of the bill. During the 30-minute visit, Dr. Sussman says his vitals were checked and blood was drawn.
At the time of the test, Dr. Sussman had a short-term insurance plan through a company owned by UnitedHealthcare. In the months after receiving the COVID-19 antibody test, Dr. Sussman received explanations of benefits from his insurance company showing his insurance company had been billed a total of $10,984 for the walk-in visit for the test. His health insurance company paid the entire bill.
Dr. Sussman said he was so shaken by the amount his insurance company was charged for the test that he resigned. "I have decided I can no longer ethically provide medical directorship services to the company," he wrote in his July 13 resignation email, according to ProPublica. "If not outright fraudulent, these charges are at least exorbitant and seek to take advantage of payers in the midst of the COVID-19 pandemic."
In a statement to ProPublica, the freestanding ER company said the allegations are false and that it "takes all complaints seriously and will continue to work directly with patients to resolve issues pertaining to their emergency room care or bill."
Read the full ProPublica article here.
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