RICHMOND, Va. -- A young Richmond couple was astonished by medical bills listing more than $40,000 in charges for potential exposure to rabies after a small bat flew into their recently purchased home near Byrd Park.
Even worse, they thought the potentially lifesaving rabies shot would only cost them $500 each.
“We woke up at 1 a.m. and Shannan says, ‘there's something in the bed,’” Dave Goodman, who described the creature as barely moving despite having made its way under their sheets, said.
Goodman easily trapped the bat in a pot and set it outside. The couple had no obvious bite wounds, so they went back to bed.
A friend later convinced them to seek medical care because rabies is 100 percent fatal in humans and bats are the most frequently reported rapid wildlife species.
Goodman’s girlfriend, Shannan Fitzgerald, called her primary care doctor and was told only an emergency room would be able to provide a critical rabies immune globulin shot to stop the virus from spreading.
The couple ultimately went to Bon Secours St. Mary’s Hospital but tried to be savvy healthcare consumers by asking for a price estimate upfront.
“They knew I was there to get a rabies shot, but it feels like they just decided not to include that on the quote,” said Goodman.
While stating it might not be the final charge, the written estimate and their conversation with a Bon Secours Patient Advocate led the couple to believe they would each be responsible for less than $500 after the hospital filed claims with their separate health insurance policies, both administered by Anthem.
“What I learned later was that was the cost of walking in the door,” said Goodman.
The cost of the immune globulin drug was listed as $18,582.65 on his bill and $17,001.45 on Fitzgerald’s bill.
Each bill also lists thousands of dollars in charges for the series of follow-up vaccines standard in post-exposure treatment. Instead of the $500 out-of-pocket costs they expected, Goodman and Fitzgerald are on the hook for their insurance deductibles of $4,000 and $3,000 respectively.
The Problem Solvers asked Virginia Health Information for data on the average cost of a hospital visit for rabies vaccines. Data submitted to the Virginia All Payer Claims Database (APCD) between October 2018 and September 2019 indicated the average healthcare provider charged $6,438 for everything from the doctor to the emergency injection and follow-up shots.
The average commercial reimbursement rate for those services was $4,196. When contacted by CBS 6, Grifols, a company that manufactures the drug associated with the billing code found on the Goodman and Fitzgerald bills, said its wholesale price for healthcare providers has remained flat over the last few years.
Price shopping for the rabies immune globulin shot is difficult for an average consumer who would need to know where to find a hospital’s price master charge sheet online and how to interpret the numbers listed.
“It's been described as trying to go buy a car where all you get is this list of like, ‘well, here's what the carburetor costs and here's the steering wheel costs and the tires,’” Dr. John O’Shea of the Mercatus Center at George Mason University, said.
O’Shea, who researches transparency in health policy, said the sticker price hospitals list on a bill, or a master charge sheet, means very little.
“They just list anything that they can bill for,” said O’Shea. “What goes into the charges? It's hard to say.”
He said the true cost of care was better depicted by the negotiated rates between a provider and health insurance company, numbers not disclosed to the public in most cases.
“It’s so opaque,” said Goodman. “You don't have a choice, right? And that's the problem. They can charge you literally whatever they want because you don't really have any recourse.”
The Virginia Department of Health reported less than 2,000 people received treatment for potential exposure to rabies in a typical year. The last Virginian to die of the disease contracted it while traveling abroad in 2017.
Following her death, VDH recommended dozens of healthcare workers receive the same course of vaccinations Goodman and Fitzgerald received. A case report indicated the drugs cost approximately $3,671 per person and were paid for by the local health department and hospitals involved in treating the patient.
Bon Secours declined to answer specific questions from the Problem Solvers regarding the written estimate the couple received, and the charges on their printed bills.
A representative sent CBS 6 the following statement:
Bon Secours handles patient and billing complaints personally and privately. Bon Secours is focused on delivering compassionate, quality care, and we have a duty to make informed decisions based on what’s best for the patient, regardless of the potential costs that might be incurred to deliver lifesaving care, every day.
Coinsurance, deductibles and copayment amounts for services provided are governed by health insurance plan benefits, which Bon Secours cannot change. We inform our patients that final charges may vary if additional or different procedures are provided, additional claims are processed with their insurance, or may include additional charges for materials, supplies, or ancillary procedures. We also inform our patients that professional fees such as physician services, radiology interpretation, or anesthesiology services may be billed separately.
Bon Secours provides financial assistance for both the insured and uninsured patient who receives emergency or other medically necessary care from any of our hospital facilities.
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