#10: Sending Insurance Checks Directly to Patients

 “ARE YOU KIDDING ME?” is the reaction the director of medical ethics for New York University’s School of Medicine, Arthur Caplan, had upon hearing of Anthem’s BCBS policy of sending insurance money to patients. My reaction would likely contain more colorful language so I will stick with his. One woman received nearly $375,000 over a period of several months for treatment she received at a California rehabilitation facility. A father received more than $130,000 after he sent his fiancée’s daughter for substance abuse treatment. In one current lawsuit, which has been ongoing for several years, Anthem BCBS is accused of sending more than $1.3 million in payments to patients. Money, owed to facilities such as our lab! Sadly the patients end up right in the middle.

It is bad enough the insurance companies practice such disgusting tactics in an attempt to force providers to join their networks where they can pay them low contracted fees, however when they send money to the most vulnerable, those with SUD or those in SUD treatment, it is reprehensible, if not criminal. In 2017, a 29 year old North Carolina man received a check for $33,000, including $2,405.28 of interest which was generated by services at an emergency department. The following four days after receiving and depositing this check, which was not his money, he made three cash withdrawals totaling $13,000 dollars. The young man who had been in treatment for SUD was found dead, from cocaine and heroin toxicity, at a local hotel on the fourth day after using the cash to go on the biggest drug and alcohol binge of his life. Somehow, Anthem BCBS claims this was not their problem.

What about labs such as ours that request to be in network with some Anthem BCBS contractors and in some cases are denied? They force us to bill out of network and then still send payments to the patients. They send sums of money to patients that at times are more than a patient sees in a year and then “wink” and tell the patient they need to send that to the provider of the services. How ludicrous to place such a burden of temptation upon patients that have difficulty with self control or self discipline. The woman in the above example received 50 checks from Anthem BCBS between August 2014 and May 2015. The treatment facility that provided the services, for which payment was made, has not seen a dime.

Many of you assist us by informing the patients who have Anthem BCBS they may receive a check from BCBS for the drug testing the provider ordered. Your reminding them it is not their money and they should endorse those checks over to the lab is greatly appreciated. Regardless of the repugnant Anthem BCBS policy, we maintain our policy of not chasing patients, even if they receive our money.

Oh well, keep on living and loving! Do the right thing, even if others don’t! Thank ya’ll for your business.

Lance Benedict

President/CEO Industry Lab Diagnostic Partners
05/17/2019