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7 Investigates: Marshfield Clinic states it has corrected COVID-19 vaccination billing issues

Updated: May. 28, 2021 at 5:41 PM CDT
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(WSAW) - Marshfield Clinic states it has fixed its issues related to billing patients for the COVID-19 vaccines after 7 Investigates shared the story of a woman who had been billed by the vaccine provider.

Following Gwen Kostrzeski’s story, nearly a dozen people reached out to 7 Investigates saying that they had the same issue, that Marshfield Clinic billed them for a flu shot after receiving a COVID-19 vaccine. Patients are not allowed to be billed for the vaccine, but vaccine providers are allowed to bill a patient’s insurance.

Lynn from Wood County, who did not want 7 Investigates to share her full name due to concerns about retaliation, said she and her husband each received a bill for $86.30 after receiving a COVID-19 vaccine in March. The next day, Lynn said she called to question the bill. She said the employee told her it was for her flu shot.

“I told them I never had a flu shot so they then said it was for my second COVID shot and I told them I never had that either,” she said. “I did have a Johnson & Johnson shot and that was supposed to be paid by the government. The person I spoke with told me that the second shot was the same price as a single J&J COVID shot and that she would put my bill on hold for 30 days.”

She said her mother-in-law also came with her and her husband to get a shot and is concerned that if she has gotten a bill, that she would have paid it without thinking about it.

Checking back in with Kostrzeski, she said on Monday, she received a reminder bill for her $86.30 shot that was due upon receipt. She was able to connect with an employee from the customer support and financial department on Tuesday.

“When I asked her she said it is not typical that Marshfield Clinic would make these errors and that they are aware of them,” Kostrzeski said.

The employee asked her for her insurance information, which Kostrzeski had already given on site when she got her vaccine.

“So, I gave it to her and then I turned around and I started asking her the three questions that have always been in my mind: how they lost to the two data inputs and only those two data input fields, why they had an error in the date of due on the billing, and why the coding was incorrect,” Kostrzeski said. “And she could not answer any of them but said they have been corrected. And I asked her if they were corrected, why was the second billing still reflecting those errors, and she could not answer.”

She also asked for a confirmation letter stating that she would not be responsible for paying the bill since she should not have been charged in the first place. She has not received that letter as of Friday afternoon.

According to the Department of Health Services’ complaints outreach tracker document 7 Investigates obtained through an open records request, a formal complaint was filed against Marshfield Clinic for a similar situation on May 19; a patient was billed for their COVID-19 vaccination.

“When I called to explain the situation, I expected to have the fee waived, but I was told if the Health Share (the patient’s insurance provider) didn’t cover it, I was responsible for it. I am not sure I should have been issued a bill in the first place, since vaccination is supposed to be free for all Americans,” the complaint stated.

Marshfield Clinic declined an interview, but sent 7 Investigates a statement in response to numerous questions:

Individuals are not responsible for any charges related to the COVID-19 vaccine. We recognize there is confusion over the administrative fee that is covered by insurance. The vaccine is paid for by the government. However the government requires insurance companies to pay for the administration of the vaccine when an individual has private coverage, and Medicare is responsible for those enrolled in the program. Administrative fees for uninsured individuals are covered through the HRSA COVID-19 Uninsured Program. So we ask patients at their vaccination appointments for their insurance information in order for the fee to be covered.

If during their vaccination appointment a patient states that they do have insurance but do not have it with them, we attempt to connect with them following their appointment to obtain that insurance information. If we couldn’t get the issue corrected, a billing statement was generated in error. We realize this has caused confusion and concern among some patients, and we take responsibility and apologize for errors that occurred during this process. Those statements are no longer being generated, so individuals receiving the vaccine will not receive any statement whatsoever going forward. We have identified those individuals who did receive a statement, and are adjusting their balances to ensure they do not incur COVID-19 vaccine charges. It is our established practice to adjust or refund charges for any procedure, visit or other provided care once we determine accurate insurance information, or if a bill was sent in error. We aim for service excellence, and when we deliver less than is expected, we strive to make the situation right.

Regarding the reference to “flu.” We certainly understand the confusion and questions from those who received a COVID-19 vaccine only to then see a billing statement referencing a flu vaccine. The reference to flu was not actually a reference to the flu shot itself, but the clinic location the shot was administered. In Gwen’s case, the statement indicated WESTON FLU. Our system uses this information in the generation of our billing statements. This was how it appeared in our billing system prior to COVID-19 because the primary vaccinations we administered were the flu vaccine. That too has been changed in our system. However, vaccinated individuals will no longer see flu referenced because statements related to the COVID-19 vaccine have ceased.

If you are billed for a COVID-19 vaccine, DHS advised people to reach out to the vaccine provider and to send DHS an email to make a report at dhscovidvaccinepublic@wi.gov. People are asked to make any other complaints against COVID-19 vaccinators to that email address as well for the DHS COVID-19 taskforce to investigate.

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