‘It Felt Like Deception’: An Elite NYC Hospital Costs Big Covid Take a look at Charges

Lenox Hill Hospital in Manhattan marketed its “Covid-19 Testing” on a big blue and white banner outdoors its Greenwich Village division’s emergency room. The banner stated nothing about price.

However price turned out to be the testing’s most noteworthy function. Lenox Hill, one of many metropolis’s oldest and best-known hospitals, repeatedly billed sufferers greater than $3,000 for the routine nasal swab check, about 30 instances the check’s typical price.

“It was stunning to see a quantity like that, once I’ve gotten examined earlier than for about $135,” stated Ana Roa, who was billed $3,358 for a check at Lenox Hill final month.

Ms. Roa’s coronavirus check invoice is amongst 16 that The New York Occasions reviewed from the positioning. They present that Lenox Hill arrives at its unusually excessive costs by charging a big charge for the check itself — about six instances the standard cost — and by billing the encounter as a “reasonably advanced” emergency room go to.

Northwell Health, a nonprofit, operates 23 hospitals in the region, and received about $1.2 billion in emergency health provider funding in the federal CARES Act last year.

The chain recently came under scrutiny after The Times revealed it had sued more than 2,500 patients for medical debt during the pandemic. It has since dropped those cases.

Northwell, which defended its coronavirus testing charges as appropriate, has since removed the blue signs at the Greenwich Village division advertising the service.

Officials said patients tested at the emergency room received more advanced care than they would elsewhere. They declined to comment on specific patient cases but said their protocols involve notifying patients that their test will come with emergency room fees. A sign with the information is taped to a plexiglass shield at the registration desk.

“I don’t think of the emergency room as a testing site,” said Barbara Osborn, Northwell’s vice president for communications.

But the Lenox Hill in Greenwich Village has tested 15,000 patients for coronavirus over the course of the pandemic. Patients interviewed by The Times said they went there because of the banner outside, not to seek emergency care. They were asymptomatic and seeking tests as a precaution before traveling or socializing.

Ms. Roa spotted the emergency room fee through an unusual circumstance. Her wallet had been stolen, and she was checking her bills. She feared her identity had been stolen because she had no memory of visiting an emergency room.

“This is such a gold mine for hospitals because now they can charge emergency fees for completely healthy people that just want to be tested,” said Renee Hsia, a professor of emergency medicine at the University of California, San Francisco, who researches medical billing. “This is what you’d expect from a market-oriented approach to health care. It’s the behavior our laws have incentivized.”

At the Lenox Hill site, Mr. Miller explained, there are actually two separate coronavirus testing processes. Patients who arrive with a doctor’s order for a coronavirus test are routed to a service center that does not charge emergency room fees.

Patients who come in without that prescription are sent to the emergency room for an evaluation, where they will incur the facility fee charges. About 75 percent of coronavirus tests at Lenox Hill Greenwich Village are routed through the emergency room, a practice Mr. Miller defended.

“Anyone who would have been billed for an emergency room visit would have been assessed accordingly to see if other things were wrong with them,” Mr. Miller said. “We believe we’re adequately disclosing that this is an emergency department visit, and will be billed as E.R.”

Founded in 1857, Lenox Hill has long served a wealthy clientele at its main division on the Upper East Side of Manhattan. It is where Beyoncé gave birth in 2012, and is the subject of an eponymous Netflix documentary series that shows the hospital’s inner workings.

In 2010, New York State awarded Lenox Hill the rights to take over the Greenwich Village building left empty by the closing of St. Vincent’s Hospital. It replaced it with a free-standing emergency room.

It would stay open 24 hours and provide care to patients regardless of their ability to pay. But unlike traditional emergency rooms, it is not physically attached to a larger hospital.

Free-standing emergency rooms have proliferated in recent years, across the country and across New York City. Montefiore, Northwell and N.Y.U.-Langone have all opened them within the last decade.

Supporters have praised them for expanding critical care access without building an entire hospital, a potential boon to underserved urban and rural areas.

But they have also faced criticism for how they price care, especially for simple visits. One analysis conducted by the health insurer UnitedHealthcare found that the average cost for a visit related to a common condition like a fever or cough was 19 times higher in free-standing emergency rooms than in urgent care centers.

“Free-standing emergency departments simultaneously represent the best, innovative side of American health care and the pure profit motive,” said Dr. Jeremiah Schuur, chair of the emergency medicine department at Brown University’s Alpert Medical School.

The prices at Lenox Hill’s free-standing emergency room caught the eye of local government officials shortly after it opened. New York City’s Community Board 2, which has jurisdiction over Greenwich Village, held a meeting in 2016 to discuss several cases. One patient was charged $1,000 to have a bee sting looked at, and another faced fees of $3,000 related to a sprained ankle.

Sarah Nathan was not looking for emergency-level care when she was tested at Lenox Hill Greenwich Village. She just needed a test to return to her job as a nursery school teacher.

The bill for her visit came to $3,194, which her insurance negotiated down to $2,084. She recalls asking a front desk representative whether she would be billed for an emergency room visit. She said she was told she would not be.

Ms. Nathan worries about the impact these high fees could have on her premiums.

“My insurance is so expensive already, and it infuriates me that they’re adding to the cost of that for New Yorkers,” she said.

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