By Sarah Kliff
November 10, 2020
Rebecca Sussman got a coronavirus test because town officials in Bedford, N.Y., encouraged her to.
“If you haven’t gotten your test yet, please do so for yourself, your family and our community,” Chris Burdick, the town supervisor, said in an email. More tests would mean a lower positivity rate, he said, and a faster path to reopening. He directed residents to the town’s new testing site, situated on an empty parking lot at the train station.
Ms. Sussman, 51, took her whole family to get tested, and the results came back negative.
Then the paperwork came: $6,816 had been charged to insurance for four coronavirus tests. Ms. Sussman’s fees alone were $1,944.
She started looking through the itemized costs. One insurance claim showed that she had been tested for a dozen respiratory diseases. She found that odd; the town emails advertised only a coronavirus test. There was also a surprise $480 charge for a short phone call relaying her results.
“That’s when I realized something was wrong,” Ms. Sussman said. “When in the history of medical appointments does it ever cost to get a phone call giving you your test results?”
The bills didn’t come from the town. They came from Dr. Steven Murphy, an internist from Greenwich, Conn., whom Bedford had selected to run its testing site.
Ms. Sussman and 10 other patients contend that Dr. Murphy used this public testing site and others nearby to run unnecessary and expensive tests. He did so with little oversight from town officials, who had advertised his services widely.
In health care, this type of billing is often described as upcoding, using codes that net high reimbursements but aren’t warranted for the medical care delivered.
“What it appears is happening is he is billing every code he can get reimbursed,” said Susan Null, a medical billing expert who reviewed patient billing documents from Dr. Murphy’s practices for The New York Times.