David Williams of Health Business Blog interviewed Dr. Catrise Austin recently about her dental practice offering rapid-result HIV testing when patients come in for their routine cleaning and dental exam. Dr. Austin would eventually like to see more dentists providing in-office HIV testing, and it makes sense that the more opportunities people have to be tested, the less likely people are to unknowingly spread the virus. Advances in medical science have made HIV much more manageable than it was a generation ago, but the first treatment step has to be detection.
Dr. Austin’s dental practice is offering the HIV testing for free, but she pointed out that if a dentist isn’t offering the test for free, patients would have to pay out of pocket, as dentists cannot currently bill health insurance companies. There is a medical code for HIV testing, but it isn’t recognized if it’s submitted by a dentist. This doesn’t make much sense, but I’m sure that there’s a combination of inertia and turf wars between dentists and primary care physicians blocking the way for dentists to be able to bill a patient’s health insurance company for an HIV test.
The CDC webpage about the OraQuick (OraSure) test doesn’t specify a cost; it simply states that the fee will be determined by the manufacturer and the lab that performs the test. I imagine it’s relatively inexpensive, otherwise dental offices wouldn’t be able to offer it for free. But anytime a test is covered by health insurance, more people are likely to get the test (think of mammograms and paps). Even if the cost of the test is only counted towards a patient’s deductible (as might be the case if the patient has an HSA qualified plan, for example), just knowing that it will be billed to the health insurance company might make a patient more likely to get the test. In addition, billing the test to a health insurance company is likely to result in a lowered final price for the patient based on network negotiated rates. All around, it makes sense for dental offices that provide HIV screening to be able to bill a patient’s health insurance company for the test.
David Williams’ article was included in Grand Rounds last week.