Northwell Health’s location at 2628 Broadway, between 99th and 100th streets (Google Maps)
Go for the COVID test, get billed for a full office visit. This is reportedly a common practice at Northwell Health-GoHealth Urgent Care. But for some, this is fraud.
That is the word two Upper West Siders used to describe Northwell billing for a full office visit when only a COVID-19 test was performed.
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One of these individuals is a former Assistant United States Attorney who made a career out of prosecuting fraud cases. He told ILTUWS that he and two members of his immediate family went to two different Northwell urgent care locations – one at 2628 Broadway, between 99th and 100th streets, the other at 2689 Broadway, between 102nd and 103rd streets — during the peak of the Omicron surge in January and February 2022.
“All we had were Covid tests with no other services.” The attorney explained that he and his family used Northwell urgent care locations only for COVID tests. He said they walked in, took the test, and left. “No one took my daughter’s blood pressure or asked about her health. There is no reason to believe any of us were seen by a doctor. No symptoms were discussed. No medical treatment was rendered.”
He explained that he later received bills from Northwell for more than $1,000 and called the testing provider to ask about the charges. He confirmed that Northwell did go through his insurance and was reimbursed for the COVID tests but that he was still charged for office visits for each time he and his family tested for COVID.
“I’m not paying for medical services I didn’t get. I made multiple calls and told [Northwell] that what they were doing is fraud, against the law, and that the U.S. Attorney’s office might be interested in this. I used to prosecute fraud cases. They’re charging insurers for office visits that didn’t happen. That’s fraud.”
Another Upper West Sider named Martha agrees. She, too, went to a Northwell urgent care (at 199 Amsterdam Avenue at West 69th Street) for a COVID test in July 2022 and was later billed for an office visit that she believes did not occur.
(Google Maps)
“Northwell billed [insurance provider] $550 for an office visit I never requested nor had. I went for a COVID Test. Apparently, [insurance provider] paid them $169. Now they are billing me for a $65 co-pay.”
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When she received the bill, she believed it was an error and emailed Northwell stating the same. A Northwell patient account specialist replied the same day with the following:
“I really understand your concern regarding the Office Visit charge that appears on the bill you received, however, it is very important to mention that each Covid-19 test is submitted to the insurance companies with an Office Visit included, I fully understand that You did not request an Office Visit, however, the Office Visit is part of the Covid-19 test, since the Office Visit includes and determines the procedures and evaluations for the provider to obtain the results and diagnosis of your Covid-19 test. For this reason, the $65.00 charge that your insurance company left is valid as they left it as a copayment, so I recommend you to contact your insurance company one more time.”
Martha has since replied to Northwell twice and used the “F” word both times. “The fact that you are billing for a service never requested is fraud,” she wrote in one email. Dissatisfied with Northwell’s lack of response and determined to keep this from happening to anyone else, she sought the help of City Council Member Gale Brewer who confirmed in an email to Martha that she had experienced the same issue.
“Northwell did the same to me. I called to complain and the charge went away.” ILTUWS also confirmed with Brewer’s office that she had a similar issue and that she intended to assist constituent Martha as best she could.
ILTUWS reached out to Northwell for comment. We received an email with the following statement from Vivek Taparia, Market President of Northwell Health-GoHealth Urgent Care:
“At Northwell Health-GoHealth Urgent Care, we offer COVID-19 testing and care, and take each encounter seriously to ensure we are helping to prevent the spread of the virus and keep our patients and communities safe, which is why visits at our centers are treated as urgent care visits. These visits include an evaluation with one of our providers to check vitals and medical history, and discuss needs, so that we may advise on appropriate test types and treatment options. Our providers evaluate every patient in the office or virtually prior to administering COVID-19 tests.
We are in network with most major insurance plans and patient responsibility, or out-of-pocket cost, for COVID-19 testing is based on specific insurance coverage. We always recommend patients contact their insurance carrier for details about your specific plan, including copays and other associated fees for COVID-19 before a visit to be sure of the costs as we are not able to determine that at the time of visit. More information can be found on our website: https://www.gohealthuc.com/northwell/covid-19-test.”
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When ILTUWS received this statement, we replied to ensure those included in that email who were issuing the statement on Northwell’s behalf understood what was being alleged. Specifically, we informed those parties that the individuals we spoke to “were all clear that Northwell provided no other services aside from the COVID test, they were not told they’d be charged for an office visit, and believe they had no reason to suspect they would because there was no medical consultation, or even checking of vitals. Symptoms were also not discussed.”
Northwell was also informed that these individuals “feel they’ve been the victims of fraud including one who is a former US attorney who prosecuted fraud.” A second emailed statement was provided in response on Taparia’s behalf:
“Due to privacy laws, we cannot comment on individual cases. But we can confirm that our COVID-19 tests are administered in our centers by providers who are evaluating the patient’s condition and health care needs. Our providers consult the patient’s medical history, engage directly with the patient including asking questions about symptoms, recent travel or known exposures and observe and document any symptoms. If there is a patient that has questions, our providers are available to review personal information with the patient directly. Additionally, we may inform patients that we do not collect co-payments at the time of the visit as many insurers cover the full cost of office visits for COVID-19 testing. When an insurer does not waive out-of-pocket costs of COVID-19 related visits, we encourage patients to contact their insurance carrier and ask that they explain their plan’s benefits related to COVID-19 services at an urgent care center.”
Haven’t had this issue at Northwell personally (have been but haven’t been charged nearly this much there). ClearMD charged insurance $1900 for PCR tests and “medical” that certainly wasn’t done.
ClearMD Aldo charged us ~$2000 for a COVID test
Same! Sent us a bill multiple times claiming that our insurance didn’t cover! I called and frankly went ballistic on them and they canceled it. They need to investigate them
This happened to me TWICE!! I emailed Northwell Health, as well as, posted a very negative reviews on Google, actually using the word “Fraud”. I ended up not having to pay anything (was told to ignore the charges/fees), but, I still think they managed to get money from my insurance company for an office visit. The first time they claimed it was an error in how they coded my visit and the 2nd time claimed that they ALWAYS code for an office visit for a covid test.
Nice reporting. Unfortunately not a surprising practice coming from Northwell.
Similar thing happened to me at City MD. A doctor breezed in, asked how I was feeling and left. I said to the practitioner giving me the Covid test, I guess that means Medicare will be charged for an office visit. She shrugged. Should I report this to Medicare?
The very same thing happened to me in the Fall of 2021 at the 2689 Broadway location where I was charged almost $600 for my “office visit”. They are not a hospital or full service medical provider by any means. My insurance company covered it because they covered the entire cost for a PCR test and “visit” at the CityMD on W. 104th street in October 2020. Since then, my insurance company has a policy since January 2022 that an office visit will no longer be covered. I agree – it’s fraud plain and simple. This was not an “office visit”. They only administered the test. It’s seem it’s less expensive just to buy your own PRC test kit it seems if you have the means. You’ll pay upwards of $450, but if you need to take the test frequently due to the type of employment you have it pays for itself. I feel sorry for those who can’t afford this fraudulent charge. These are most likely the people who need that test the most. Welcome to “health care” in the United States.
All who were billed for medical services that were not rendered or agreed upon should file a complaint with the NYS DOH as well as the NY DFS. There is an appeal and grievance process that Northwell has in place and you should access it for the maximum . I would file a fraud and abuse claim with your insurance company as well.
There is a related scam that bills the government circa $800 for a simple swab covid test at a street testing center (this happened in December on West 72nd Street. Turns out they tested for antigens and a lot of things but did not inform me of that fact (I needed only to know if I was negative before visiting an elderly relative.) Was billed to Medicare but they didn’t pay. So much for a “free’ test….
It’s terrible one hand we want to sue and stop them the other we have to have the care it’s clearly case or required government assistance in opening force priced offices period .. I noticed a high price list for free covid tests too at one of these near 72 and recently even the outside vans are refusing to take a test without payment they seriously kind of kill us for a dollar and greatly too ones we start infecting each other unfortunately there are just mean criminal minds that work at places like that they should just have better staff at all
Looks like in this case the marketing VP was told by her bosses that Northwell isn’t going to stop billing for office visits for covid tests so get out there and defend it. This practice will likely continue.
Maybe people should just stop testing for COVID. If you feel sick, stay home. Doesn’t really matter whether it’s a cold, flu, COVID etc. If an employer requires a test, they should pay for it. These tests are not catching it early enough to prevent spreading it anyway.
That makes perfect sense & I concur with you @JayNYC because it seems to just be a big money making racket. The percentage of asymptomatic spread is so small but people who feel symptoms (cold, flu, covid, ect…) should stay home & stay away from others. Basically like they told us when we were in grade school, if you’re sick, stay home & keep your germs to yourself. All these people complaining about being charged at Northwell are just running in circles because it says URGENT CARE right on the front of the door so why would anyone think they could just waltz in and get a “free covid test”. Common sense would tell me that I can get tested for free at a tent on the street but I’ll go to an urgent care when really sick so I can be treated for your illness. Northwell is not a covid testing center so no one should expect to JUST be covid tested with no other services.
Just received a bill from them for a covid test taken TWO years ago. Quickly reported them to NYS insurance fraud department. Suggest you all do the same!! do not let this corrupt business take advantage of you!!
I appreciate your comment. Will do the same. They should have to tell you prices of non-emergency treatments prior to treatment.
Similar experience on Long Island. I was told the fee is $195 and they take my insurance. I stupidly assumed my total would be under $195 after insurance. Because I have insurance, they billed me $585, but if I had paid cash day of, It would only be $195. This seems fraudulent and deceptive. If I was told the true price, I would have declined service.
I am having the same issue with Northwell Go Health — I went in for a strep test and was told without insurance the total cost would be $120. The receptionist encouraged me to use insurance such that I would only have to pay $75. I said my insurance was pretty basic and might not cover much; she said the $75 is all I would have to pay. Now I am being charged net $150 which feels fraudulent — Northwell says they charged my insurance who didn’t pay and now I must pay. I could have paid less by skipping the insurance option.