CHARLOTTE, N.C. — A billing change meant to reduce health care costs and improve medical access during the COVID-19 pandemic has the potential to cost some uninsured patients more money.
Kyle Benjamin of Charlotte learned that the hard way.
Afraid he might have COVID-19, Benjamin visited a Novant Health clinic virtually three times in April. Self-employed with only temporary work and a family of four, he thought, based on past experience, it would cost him just $50 per visit.
He was wrong.
"It was a huge surprise," he said. "I don't want to say inconsiderate, but it's a little inconsiderate."
Benjamin said he didn't undergo any tests. Instead, doctors treated him for pneumonia and prescribed two rounds of antibiotics, steroids, an inhaler and some cough medicine, he said. Weeks after, Benjamin said Novant blindsided him with an almost $500 bill.
"We got the bill back at the start of May — we didn't have $500 to pay that bill," he said. "I don't have $500 to pay it now."
It turns out this is not isolated. At Novant Health, a video visit used to cost a flat fee of $50, but then COVID-19 hit and the insurance industry started covering televisits.
That was great news for people with insurance, because it eliminated upfront charges, provided more coverage and resulted in the potential for less expensive bills. However, for those like Benjamin without insurance who self-pay, there was the potential of a greater cost.
Regardless of your so-called payer class, Novant Health is now contractually required to file telemedicine claims at its traditional rates, which means today virtual visits are basically billed at the same rate as in-person visits.
That is contrary to what WCNC found on a section of the health system's website Tuesday detailing a $50 flat fee. Novant Health updated the language after WCNC started asking questions.
"Not once were there any indications you would be charged above and beyond what their standard video visit rate was," Benjamin said. "Had I known that I probably would have just gone for the first visit and not the subsequent follow-ups and honestly, would've just taken my chances."
Benjamin and his family have since entered into a payment plan. While he can chip away at the bill, he knows others are not as fortunate.
"I know I'm not the only one in this position," he said.
A Novant Health spokesperson said out-of-pocket expenses will differ for every patient.
"COVID-19 has prompted a variety of policy changes by both insurance companies and government agencies, which Novant Health is contractually obligated to meet," the spokesperson said. "One such change is the need to bill video visits differently. While this change was made across the board for all patients, the impact will be different as no two patients are alike. Many factors affect a patient's out-of-pocket costs for a visit or procedure – their insurance plan, deductible, copay and annual income if they don't have insurance coverage."
The health system said it has programs available to help patients who struggle to pay their bills.
"Novant Health is committed to providing accessible and affordable care – irrespective of the requirements we have to meet in our fee and billing structure," the spokesperson said. "Our financial assistance programs can help patients by adjusting, discounting or eliminating healthcare costs, depending on each individual's eligibility. Financial navigators are available to help patients better understand their healthcare expenses, including what financial assistance is available to them. To contact a financial navigator, please call 1-888-277-3901, Monday through Friday, 8 a.m. to 6 p.m. Voicemail is available for after-hours or weekend calls."
Our attempts to reach Atrium Health for comment on this story were unsuccessful.