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For the past few months I’ve started my mornings with the same routine: checking medical bills for New York Times readers over coffee.
The documents are part of a project I started in August that asked readers to submit fees for testing and treating coronavirus. The bills can contain important information that hospitals and doctors often keep secret, such as: B. the actual cost of hospitalization or the fees, which vary from patient to patient. A few trickles every day and I look over everyone.
If you read enough – I’m at 400 and counting – they can also show patterns of how providers bill patients. So I came up with my latest story, which is about a Greenwich, Connecticut-based doctor named Steven Murphy. Patients claim he used public testing sites to conduct unnecessary and expensive tests. Dr. Murphy defended his accounting practices, saying he was providing an important service to the community.
The only reason I noticed the story was the large number of patients who sent invoices from his test sites in the northern suburbs of New York City. Without this wave of readers’ contributions, I would never have known something was going wrong.
The first invoice with this provider was sent to me on August 3rd, the same day I started the debt collection project. A woman from outside of New York City said she was “shocked” to see a drive-through coronavirus testing site billed her insurance company $ 1,944. “How can this provider charge $ 480 for a 3-minute phone call with test results?” she asked in her submission.
The next day another submission came from a patient of Dr. Murphy adds, “I can pay my bill, but am amazed at the cost the provider charges for the test,” the patient wrote. Four days later, another patient reported the “exorbitant rates” she faced, also from Dr. Murphy.
When the first bill came in I found it interesting but didn’t see a full story. The high stress on the patient can be an anomaly. By the end of summer, I had six separate bills and a clue that something was wrong. I had slowly amassed a data set showing that a doctor hiring public testing sites repeatedly billed insurers over $ 1,000 for coronavirus testing.
This is information that powerful healthcare lobbies typically try to keep secret. The American Hospital Association recently sued the Trump administration over new rules that would make health awards public (they lost that challenge but have announced they will appeal to a higher court). This makes it frustratingly difficult for reporters and patients to answer seemingly basic questions, such as how much a coronavirus test costs in the US.
The patients who went to one of these drive-through checkpoints had no chance of knowing what fees they would face in advance. However, your bills can help shed light on the problem. They put secret prices in sight.
They also contain five-digit billing codes that I read the better the longer I studied the healthcare system. These codes show exactly what service the doctor provided. In this case, these codes alerted me that Dr. Murphy didn’t just bill for coronavirus tests, as his patients thought. He also reckoned with 20 other respiratory pathogens.
The bills are important, but they’re never the whole story. After accumulating enough bills to see a pattern, I began asking patients about their experiences. I have talked to Dr. Murphy talked about his accounting practices. He said the larger test was appropriate to use as it could capture a wider range of diseases, especially those who were symptomatic.
I spoke to medical billing professionals to get their findings and to the elected officials who set up the testing sites. I filed public record requests and when they got back I combed thousands of pages of email between Dr. Murphy and city government officials.
For the most part, the patient bills I receive don’t turn into stories. Some do not reveal any new information. From those who do, we often don’t have enough submissions to show a pattern or the ability to study each one.
In this case, however, we were lucky: a critical mass of readers decided to take a few minutes to send us a medical bill that they found strange. Your choices enabled me to do better at my job and tell a story that otherwise might not have been told.