{"id":6815,"date":"2020-09-30T09:05:00","date_gmt":"2020-09-30T05:05:00","guid":{"rendered":"https:\/\/www.medisysdata.com\/?p=6815"},"modified":"2023-10-31T19:44:51","modified_gmt":"2023-10-31T14:14:51","slug":"out-of-network-covid-19-test-cost-is-higher-than-the-commercial-price","status":"publish","type":"post","link":"https:\/\/www.medisysdata.com\/blog\/out-of-network-covid-19-test-cost-is-higher-than-the-commercial-price\/","title":{"rendered":"Out-of-Network COVID-19 Test Cost is higher than the commercial price"},"content":{"rendered":"\r\n

According to a new report provider prices for out-of-network COVID-19 tests are higher than the average cost of in-network tests. America\u2019s Health Insurance Plans (AHIP) is calling on the government to stop price gouging after finding provider prices for out-of-network COVID-19 tests far exceeded the average cost of in-network tests.<\/p>\r\n\r\n\r\n\r\n

In a report released late last week, AHIP stated that out-of-network test providers charged more than $185 for nearly 40 percent of diagnostic tests and 25 percent of antibody tests even though the average price of a COVID-19 test in the commercial market is $130. In a small number of cases, out-of-network providers charged over $390 for the COVID-19 tests.<\/p>\r\n\r\n\r\n\r\n

The survey of health insurance providers in the commercial market also found that almost a tenth (9.4 percent) of all claims for COVID-19 tests were from out-of-network providers.<\/p>\r\n\r\n\r\n\r\n

\u201cThe Administration should take steps to prevent price gouging for COVID-19 testing, including enforcing the requirement that test providers publicly post their cash price in an easy-to-find online location,\u201d the industry group said in the report.<\/p>\r\n\r\n\r\n\r\n

The Coronavirus Aid, Relief, and Economic Security (CARES) Act<\/a> passed in late March 2020 requires health insurance providers to give beneficiaries access to medically necessary COVID-19 testing without cost-sharing.<\/p>\r\n\r\n\r\n\r\n

The law also requires the providers to pay providers the listed cash price for the tests in the absence of a contract.<\/p>\r\n\r\n\r\n\r\n

The requirement, however, eliminates a health insurance provider\u2019s ability to negotiate a more affordable price for COVID-19 tests, AHIP stated in the report.<\/p>\r\n\r\n\r\n\r\n

Patients are protected from the prices providers have set for COVID-19 tests thanks to the CARES Act and subsequent pandemic-related legislation, which not only requires health insurers to pick up the tab for medically necessary COVID-19 tests, but also prohibits providers from balance billing patients for the tests and related care.<\/p>\r\n\r\n\r\n\r\n

How Can We Stop Price Gouging of Americans?<\/h3>\r\n\r\n\r\n\r\n

Everyone should be able to get the COVID-19 tests they need, whether they have health insurance coverage or not. To stop price gouging:<\/p>\r\n\r\n\r\n\r\n