The Great Smoky Mountain Journal
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Posted: Tuesday, January 01, 2019 02:34 PM
Normal Test To Check For Opioid Costs Texas Woman $17,850
When Elizabeth Moreno had back surgery in 2015, her surgeon prescribed an opioid painkiller with a follow-up drug test.
For Moreno, it seemed pretty routine. What didn't seem routine was the $17,850 bill.
The pregnant woman who is still finishing her degree at Texas State University had no idea it would cost this much.
According to CNN News, Sunset Labs LLC, a Houston lab, had tested her urine sample for legal and illegal drugs. Moreno said she hadn't heard of many, let alone taken any of them.
Check her urine -- $4,675
Check for benzodiazepines (drugs to treat anxiety) -- $2,975
Check for amphetamines -- $1,700
Tests to detect cocaine, marijuana & phencyclidine -- $1,275
Test for buprenorphine (drugs to treat opioid addiction) -- $850
Two tests to verify nobody had tampered with urine specimen -- $850
In all, her bill totaled at $17,850.
CNN said these are lab test that her insurer, Blue Cross and Blue Shield of Texas, would not cover. Apparently this lab was not in her insurance network. According to Moreno, the insurer sent her an "explanation of benefits" and it said they would have valued the lab work at just $100.92.
Moreno's father sent a complaint to the Texas attorney general's office regarding the bill. He identified the Houston surgeon who ordered these expensive tests as Dr. Stephen Esses. According to Kaiser Health News, the surgeon had no comment.
Kaiser Health News also interviewed three experts who said the lab charged her far too much. They also said they doubted the need for the test.
Charles Root, a veteran industry adviser, said a test like this should really only cost a few hundred dollars. He questioned whether the lab "misplaced the decimal point" and said it "sounds really fishy."
The lab didn't agree.
This is a complex test, so the attorney for Sunset Labs LLC, Justo Mendez, sent an emailed statement stating Sunset's billings "are in line with the charges of competing out-of-network labs in the geographical area".
Mendez mentioned that the extensive urine testing is "the best course of action" and the lab "is not in a position" to question tests ordered by a doctor.
According to CNN, urine testing for patients with chronic pain has exploded and grown over the past decade. It helps doctors make sure patients are taking the drugs prescribed and not mixing with illegal substances. At the same time, it costs billions of dollars every year. This has raised concerns if running urine tests or if the astronomical rates are really just being used to boost profits.
The Blue Cross spokesman, James Campbell, said he couldn't discuss a specific case, but he did say this.
"We are disappointed as well as concerned about transparency whenever [any] member is surprised by an excessive charge for a seemingly routine service or received services that may not have been medically necessary."
CNN said some insurers have refused to pay and this could leave patients with an incredibly high bill they had no idea they had.
Here's the deal. The price for urine tests vary. According to CNN, it depends on the complexity and the technology. A simple cup test rarely costs more than $200. On the other hand, a test that checks for multiple drugs and bills each one, can really rake up your bill at the end of the day.