Duke Health wrongly billed some patients for COVID vaccines. What to do if you were charged
If you received a bill after getting a COVID-19 vaccine or booster, it may have been in error.
That’s what happened with some Duke Health patients who were billed for administrative fees related to COVID vaccine or booster shots. Duke Health told The News & Observer that since September 2021, fewer than 700 patients were billed by mistake.
“The average assessment for those fees was $20, and we are now working to refund any payments received from patients,” Duke Health officials told The N&O through Sarah Avery, director of the Duke Health News Office.
“We regret the error and have redoubled efforts to ensure it is not repeated.”
Alice Wilder, a freelance journalist, received a bill for $120.02 on Dec. 30, about a month after receiving her booster shot through a Duke Health walk-in clinic. The bill, which was shared with The N&O, said that her insurance, Blue Cross and Blue Shield of North Carolina, would cover two cents of the total, so the remaining $120 would need to come out of pocket.
We reached out to the North Carolina Department of Health and Human Services and to Duke Health, to find out what happened.
The federal government pays for the actual vaccine, but there are administrative costs associated with storing and administering the vaccines, running clinics and keeping records, The N&O previously reported.
Vaccine providers, such as doctors offices and pharmacies, are allowed to bill insurance companies for these fees, but they are not allowed to bill patients, Catie Armstrong, a press assistant for NC DHHS, told The N&O. Those administration fees should be covered by health insurance companies.
This is true even for patients who don’t have health insurance.
Here’s what you should do if you received a bill for your COVID-19 vaccine or its administrative fees:
What to do if you’ve been billed for your vaccine
We consulted NCDHHS, Blue Cross NC and the NC Department of Insurance to learn what to do if you receive a bill for your COVID-19 vaccine or its administrative fees. Here’s what they recommend:
▪ Contact your vaccine provider: “If individuals accidentally receive a bill for a COVID-19 vaccine, they should contact the vaccine provider or the organization that sent the bill for more information,” NCDHHS’ Armstrong said.
Centers for Medicare & Medicaid Services’ website says that all participants in the CDC COVID-19 Vaccination Program must “administer the vaccine with no out-of-pocket cost to your patients for the vaccine or administration of the vaccine.”
All organizations that administer COVID-19 vaccines and booster shots are a part of this program, said Kelly Haight, communications manager for NCDHHS.
▪ See if you were billed for a procedure unrelated to your vaccine: If you got your COVID-19 vaccine or booster while seeing your healthcare provider for a medical check-up or another unrelated reason, make sure you were not billed for the vaccine or any related administrative fees.
“Patients who get the vaccine while having an appointment for another reason, such as a medical check-up or another reason for visiting a healthcare provider, may be charged for those services depending on their insurance,” NCDHHS’ Armstrong said.
▪ Contact your insurance carrier: Find out how you can contact your insurance carrier’s customer service team, said Laura Eberhard, Blue Cross NC’s communications specialist.
“If a member has questions about a bill, they should call the customer service number on the back of their member ID card,” Eberhard said. For more information about contacting Blue Cross and Blue Shield of NC, visit their website at bluecrossnc.com/contact-us.
▪ File a complaint with the NC Department of Insurance: The SMART NC program can help you sort out disputes with your health insurance company. This program is free to use. For more information, visit ncdoi.gov/consumers/health-insurance/health-claim-denied.
Call 855-408-1212 to get assistance with filing a complaint. Find online complaint forms and more at ncdoi.gov/assistance-or-file-complaint.
▪ File a complaint with the U.S. DHHS’ Office of Inspector General: NCDHHS’ Armstrong also recommended filing a complaint through CMS, which leads you to the Office of Inspector General.
Read up on what to do before you submit a complaint by visiting oig.hhs.gov/fraud/report-fraud.
▪ Bottom line — don’t pay the bill: NCDHHS made it clear that patients should not be paying out of pocket for vaccines or administrative costs related to the vaccine. If you receive a bill saying you must pay out of pocket, it was done in error.
“The vaccine providers are not able to charge you for the vaccine or the administration of the vaccine, even if you don’t have health insurance,” NCDHHS’ Armstrong said. “Administration fees should be covered by all health insurance companies and will also be covered for those who are uninsured.”
This story was originally published February 4, 2022 at 2:46 PM.
