A $28,000 Case of the Sniffles

By Jon Coss, CEO

January 2, 2020

Imagine going to the doctor because you just can’t shake that cold before the holidays and then receiving a bill for $28,395.50.  Sounds crazy but that’s exactly what happened to a 40-year-old New York woman this December.  During the visit, she had a throat swab, had blood drawn, was prescribed antibiotics, and then sent home.  Pretty typical visit to the doctor.

What wasn’t typical was what happened next.  Her primary care physician decided to order some “unnecessary and unusual tests” for the follow up.  So unusual that a Georgetown University doctor said that he’d never ordered any of the tests, or seen any of his colleagues order the tests, in 20 years of practicing medicine.

Here’s where things get even worse.  The lab where the tests were performed?  Turns out that it had the same phone number and address as the doctor’s office.  Hmmmm.  And what did the insurance company do when they received the bill?  They paid it and only stopped payment after being called by the patient who noticed the ridiculous charges on the bill.

The insurance company admitted that they did not perform the necessary checks for excessive billing “in this case”.  And while this may sound a bit comical, it’s not.  Unfortunately, unscrupulous doctors know how to scam the system and these costs get passed to you and me in the form of higher insurance costs.  And if they’re willing to scam the system this way, would they also be willing to put patients at risk for a few more bucks?  Unfortunately, many are more than willing.


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