Cost and Access Barriers Complicate COVID-19 Testing

In early November, the dreaded call finally arrived. I was strolling into a store on a Sunday, lightly browsing on my way to the checkout counter to make a return thanks to my ongoing pandemic-induced online shopping frenzy, when someone I’d come into contact with the week before called to let me know they’d just tested positive.

No, not for an STD — though the immediate stigma that came with the news made it feel that way. Rather, positive for COVID-19.

To my relief, the family member who had called was feeling fine — completely asymptomatic. Still, I panicked. I dropped everything and immediately left the store to tackle my next task: notify anyone I could’ve possibly come into contact with, and get tested.

Easier said than done. Getting this news on a Sunday didn’t make my pursuit of a test any simpler. It was late in the day, so almost every facility I found online was closed. I was looking for rapid-result (antigen) testing availability, and sifting through the pieced-together, crowd-sourced lists on the internet was almost humorous. The information was often outdated, plus conflicting from one resource to another.

This was the second time I was seeking a COVID-19 test. I decided to look online at the urgent care clinic I’d visited in early October. At the time, my boyfriend had mild cold-like symptoms, so we got tested out of an abundance of caution. (We were both negative.) Back then, we had driven to the clinic, added our names to a waiting list and got a call within three hours that it was time to get some cotton swabs shoved up our noses. We received our results less than three hours after that.

[READ: Protect Your Family’s Mental Health During the COVID-19 Pandemic.]

Unfortunately, that clinic — which has three locations in the Washington, D.C.-area — had shifted to appointment-only, and there were no open slots for at least the next seven days. I tried calling a few times to confirm, but nobody picked up.

I circled back with my family member, who also lives locally, and asked about their testing process. They gave me the name of another urgent care clinic they’d gone to. The clinic had Sunday hours and was still open. I called, and called again … and then again. Over and over, I got a message that they were experiencing a high volume of calls. I never got through, so I decided to drive over (fully aware how lucky I am to own a car and have the option to drive to many of these sites). I masked up, stood way more than 6 feet away outside the front doors while I spoke to the receptionist and was able to get myself added to a wait list. I was pretty astounded that all they took down was my first name and a phone number to reach me. They said they’d call but couldn’t tell me when. “Definitely not tonight,” the receptionist told me. “Probably not tomorrow either. I have no idea. We’re backed up for days on our messages of people trying to schedule appointments.”

I left without confidence I’d be tested there anytime soon, so it was back to the drawing board. I looked up every CVS and Walgreens location within 30 miles of the D.C. area, to no avail. It would be days before the next available appointment.

On Monday morning, I began making my way through a list of places I could potentially be rapid tested. I repeatedly hit that same recording: We are experiencing a high volume of calls right now.

I eventually reached two different urgent care centers. One could offer an appointment the following day. The other said they only accepted walk-ins, and that if I got there immediately, they could “probably” test me that day. I asked for the cost: $275. “And we don’t accept insurance,” they emphasized.

[READ: Using Telemedicine — and Teletherapy — With COVID-19 Circulating.]

Navigating Payment

I knew my insurance plan covered 100% of COVID testing from an email I’d received weeks earlier. But I wasn’t sure how exactly it worked, so I called up my insurance company.

The first agent I spoke with seemed uncertain in some of his answers — lots of “um’s” and “let me check.” So for peace of mind, I called back a second time to have the same conversation over again with another agent. Both confirmed that 100% of a COVID-19 test would be covered, no matter where I went. The second agent walked me through the reimbursement process — I’d need to make sure I had the receipt (complete with ICD-10 codes, which providers use to classify the diagnosis or procedure), fill out a reimbursement form through an online portal and submit the form for reimbursement.

Three weeks later, an email finally landed in my inbox: denied. My insurance company had denied my reimbursement claim — the same one they said would be covered. I put my outrage aside and responded through the insurance portal, letting them know I’d confirmed with two different agents beforehand that the test would be covered.

Thankfully, the company responded the next day. “We have reviewed and determined that this claim was incorrectly denied. We apologize for any inconvenience,” the message said. “We have resubmitted the claim for reprocessing and this claim should be reprocessed within 7-10 business days. Once the rework has been completed a revised explanation of benefits will be provided to you.”

It’s been nearly five weeks since my initial claim submission — and 13 business days since the resubmission claim for reprocessing — and the $275 reimbursement still hasn’t seen the light of day.

[SEE: At-Home Supplies for COVID-19.]

My Tips for Testing

Fortunately, my boyfriend and I both tested negative for COVID019. I asked the doctor if we should get a “regular test,” as I called it, meaning a PCR test. He said that wasn’t necessary on top of a rapid test unless I developed any symptoms in the next few days. In that case, he said, I should get tested immediately.

Testing processes and accessibility will vary largely by location. You may not need a test right now, but it doesn’t hurt to be prepared for if and when that moment comes. As a starting point, here’s what I recommend:

Find testing sites now. Know your state’s testing options. My experience in the Northern Virginia area just outside of D.C. won’t necessarily be the same as yours. Gather resources now, before you reach that panicked moment when you’re frantically trying to find a testing site. If the time comes when you need a COVID-19 test, you’ll have a ready-to-go list of locations to start with.

Ask friends and family. Do you know someone who’s gotten a coronavirus test recently? Ask them about their experience — everything from appointment scheduling to wait time to the payment process. Word-of-mouth recommendations are one of the easiest ways to find an accessible testing site.

Contact your insurance company. If you have health insurance, become familiar with their testing coverage policies. Will they cover the cost of a test? Do they reimburse if the testing site doesn’t accept insurance? And when in doubt, ask for a copy of the information in writing. If you don’t have insurance, many states offer community testing sites with free walk-in or drive-up options available.

Be persistent. Don’t give up. When my insurance claim was denied, it would’ve been easy to accept that as fact and move on, eating a $275 personal loss. But a follow-up confirmed the denial was an error. I’ll continue to stay on top of it to ensure I’m correctly reimbursed.

Hopefully, you won’t have to face this moment. Especially with the holiday season approaching, keep up the frequent hand washing, avoid gatherings and don’t forget to mask up. And if you have reason to suspect you’ve been exposed, make sure to self-isolate immediately and seek out a test.

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