Physician says employer charged $11,000 for COVID antibody test

A Texas-based pathologist resigned after learning his employer charged his insurance company nearly $11,000 for a COVID-19 antibody test. Zachary Sussman, MD, said he decided to use one of the freestanding ERs owned by Physician Premier ER, so he could witness the patient experience offered by his company. At the time, Sussman worked as a part-time medical director for Physician Premier ER and oversaw antibody testing at four of Physician Premier’s other locations. According to Sussman, the materials for the antibody test cost $8 and can be read on the spot.

Sussman later received an explanation of benefits from his insurance company (a company that is owned by UnitedHealthcare). The insurance company was billed $10,984 and paid the entire bill. Although Sussman did not have to cover any portion of the bill, he says he was horrified that his employee billed his insurance such a large amount.

“I have decided I can no longer ethically provide Medical directorship services to the company,” he wrote in his July 13 resignation email. “If not outright fraudulent, these charges are at least exorbitant and seek to take advantage of payers in the midst of the COVID-19 pandemic.”

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COVID-19, Quality