SAN ANTONIO – Richard Garza’s wife is a dentist in San Antonio. As a health care worker, she wanted to secure COVID-19 vaccines for herself and her husband as fast as she could.
So in early December, just weeks after the vaccines were approved for use, Dr. Kelsey Garza began the hunt for appointments.
“I work directly in people’s mouths and in aerosols and everything, so I feel like it’s a little bit higher of a risk. So I definitely wanted to get vaccinated as early as possible,” Dr. Garza said. “(Richard) is exposed to me and he does fall into 1B, so he’s at a higher risk of getting severe COVID-19 illness. So I wanted to make sure that we got him vaccinated as soon as possible as well.”
Dr. Garza secured her appointment at a local hospital. But, she booked Richard’s appointment at a Christus Promptu Urgent Care, located on Culebra Road on the far Northwest Side.
”I was checking a lot of different places pretty regularly and as soon as a slot opened up, I just put him in there,” Garza recalled.
On January 15, Richard Garza rolled up his sleeve and got his first jab of the Moderna vaccine.
”They asked me which arm I wanted the shot in and it was very quick,” Richard said. “And before I knew it, I was just waiting in the observation time period and then I left.”
Garza returned to the same location on February 12, for his second shot. He said at both visits, the only service provided to him was the vaccine shot. The Garzas were now fully vaccinated and thought that was the end of the process, but 15 days after getting that second shot, they got a surprise bill in the mail.
”I just kind of turned to him and I was like, we got a bill for your COVID vaccine,” Dr. Garza said. “And of course, I was really surprised because I knew it was supposed to be free.”
The bill for the two visits came in at $394.39 but the invoice didn’t even specify what they were being billed for. It only listed “medical services.” He was being charged $183.00 for the first visit and $211.39 for the second.
Dr. Garza said she contacted the company’s billing department to point out what she believed was a mistake.
”But they didn’t acknowledge any error on their part,” Dr. Garza said. “I also let them know that I was going to appeal with the insurance because I did know that it was possible that they could charge out an administration fee.”
When their insurance provider refused to cover the charges, the Garzas filed an appeal, which was denied.
”All that they said was after review, they were upholding their decision to keep the charges for the urgent care visit.”
The problem, according to the Centers for Disease Control and Prevention, is that vaccination providers cannot charge you for the vaccine or charge you directly for any administration fees, co-pays, or coinsurance. They can, however, seek reimbursement from insurance providers for a vaccine administration fee, but they cannot charge you the balance of the bill.
In other words, you should pay nothing for the vaccine.
”I feel like the entire thing was an error and that they just kind of need to make sure that they’re in compliance with the rules for vaccination providers,” Dr. Garza said.
According to the Office of Inspector General of the U.S. Department of Health and Human Services, problems like this are not just happening in Texas. According to information on the agency’s website, the OIG is aware of complaints by patients about these charges by providers.
The agency said those providers who charge the impermissible fees must refund the money and stop charging the fees. So how did this happen to the Garzas?
The Defenders reached out to representatives for Christus Health and asked for an interview, which they declined. But on the same day they were contacted by the Defenders, Christus informed the Garzas they no longer owed anything.
”She was very forthcoming and apologetic and was like, ‘This was first and foremost a billing error and now we are doing everything we can to clear your account,’” Richard said, recalling the phone call. “I think in all honesty, it truly was a billing error and something that was just kind of overlooked at the moment whenever it was happening. I do believe that this process has kind of helped bring it to light and maybe drove some action where it might have dragged a little bit more.”
In a statement to the Defenders, Christus Health said:
”CHRISTUS Health always takes concerns from our patients seriously, and this situation is no different. As soon as we learned of this issue earlier this month, we immediately began communication with the billing vendor to resolve this error. We confirmed that as of Monday, we settled this patient’s account and ensured that there was no charge for the vaccine. We are deeply sorry for the error and the inconvenience it caused, and will always work to ensure that the same happens for everyone who visits one of our facilities for a COVID vaccine. To date, CHRISTUS has administered tens of thousands of vaccines in communities across the state, and we look forward to continuing to meet that need.”
While their issue has been resolved, the Garzas have some lingering concerns about what happened to them and possibly other patients.”There’s really no telling how many people it happened to and are they going to resolve it when those people reach out or are they actually, like, looking into it on their own?” Dr. Garza said. “I just think it’s important for everyone to really know that they’re not supposed to be paying for the vaccine.”
The Garzas said they hope Christus Health sticks to its word and fixes any other errors that may have occurred. But they also worry about the effect mistakes like this could have on people’s decision to get vaccinated.
”My big fear is that if people hear that they might be charged or billed, that they’re just not going to get the vaccine, which is the worst-case scenario,” Dr. Garza said. “We don’t need any further barriers for people to getting the vaccine.”
If you got your vaccinations and ended up with a bill like the Garzas, the Defenders would like to hear from you and so would the federal government. You can file a complaint against a provider with the U.S. Department of Health and Human Services Office of Inspector General here.
You can share your stories with us by sending an email to firstname.lastname@example.org.