American billed to $ 48 000 for allergy tests

Janet Winston had a rash that did not disappear.

Фото: Depositphotos

A professor of English from the state of California has always been sensitive to ingredients in creams and cosmetics for the skin. This time, the problem was an antifungal cream, which she was prescribed to cure the rash. But over time, the situation deteriorated.

Janet Winston's 56-year-old knew that a dermatologist in her rural city in Northern California was busy several months ahead. Therefore, since she often deals with specialized treatment, she turned to Stanford Health Care — almost six hours south. She hoped to finally clarify the cause of her rash and find out what else she might have an allergy. For years, she avoided lipstick and other skin products.

Winston told me that during the three days of testing, 119 tiny plastic containers with allergens were attached to her back. This made it possible to determine that Winston is allergic to: linalool (a compound of lavender and other plants), gold, nickel and cobalt, ketoconazole cream for treating its persistent rash, antibiotic neomycin, and a general preservative used in cosmetics.

Her doctor at Stanford Health Care warned that extensive allergy testing could be expensive, but she wasn't too worried because Stanford Health Care was an in-network provider for her insurer—one of her benefits as a California government employee.

Everything changed when the bill came.

Patient: 56year Janet Winston, Eureka, California, Professor of English at Humboldt State University

Total cost: $ 48 329, including $ 848 for the time Winston spent with his doctor. Winston Insurance Company, Anthem Blue Cross, paid Stanford Health Care a $ 11 376,47 compensation percentage. Stanford Health Care billed Winston an $ 3103.73 account as its 20 percentage at an agreed rate.

Service Provider: Dr. Golara Honari from the out-patient dermatology clinic at Stanford Medical Center in Redwood City, California.

Medical procedures: Extensive skin allergy testing to determine which substances have caused Winston contact dermatitis or skin rashes.

Medical billing analysts told Kaiser Health News that Winston's billed allergy testing was overstated. They were surprised to learn that the insurer Winston, Anthem Blue Cross, paid Stanford Health Care more than 11 000 dollars for the treatment.

However, the cost of testing each allergen at Stanford Health Care is $ 399.

“This bill is astronomical,” said Margaret Skurka, a retired professor of health informatics at Indiana University and a medical coding and billing consultant who advises hospitals and providers.

"The usual and reasonable" test for a single allergen in the high-cost area of ​​San Francisco Bay is about $ 35, said Michael Arrigo, a medical expert in San Francisco, who also reviewed Winston's bill.

Medicare charged $ 2016 for each allergen in 16.

Anthem Blue Cross spokesman Eric Lyle responded by email: “We are trying to strike a balance between accessibility protection and the provision of a wide network of providers to choose from.”

Resolution: after bargaining with the billing department, Winston eventually paid $ 1561,86 in cash.

As practice shows, such inflated bills for medical education are not new. Thus, Drew Culver, who was hospitalized last year in Austin, Texas, due to a heart attack, got for the medical services provided six-digit account.

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