Earlier this year, I got a strongly-worded email from my parents with a question about my health insurance. Immediately, I called my mom – and she explained that a company called UBiome was trying to bill us for thousands of dollars worth of medical tests.
My heart sank. I knew exactly what she was talking about – because I’d qualified for UBiome’s patient assistance program for their clinical SmartGut test.
The good news is that we were able to sort out the issue with UBiome, so that my insurance company would be paid via their patient assistance program. The bad news is that, upon doing that research, I discovered that we weren’t the first family to be slammed with medical bills from UBiome.
Here’s the story of how I, seemingly harmlessly, signed up for a free trial of the SmartGut test from UBiome – and ended up with thousands of dollars in medical fees.
What is SmartGut?
At the time I joined, UBiome’s SmartGut test was in the early stages of clinical. trials. I became one of the first testers of the product and, via UBiome’s patient assistance program, had the entire testing process paid for by UBiome.
The SmartGut test – and its results – were actually pretty cool! After swabbing one small stool sample, UBiome could culture a sample of my gut bacteria, identifying potential pathogens and markers for conditions like IBS and IBD.
With SmartGut, I learned of my lactose and gluten intolerance for the first time, which set me down the path toward being diagnosed with and treated for IBS. Without SmartGut, I may not even know that I have IBS today.
But unfortunately, along with the pros of SmartGut, there are also some pretty big cons – one of them being that UBiome is now being investigated for its controversial billing tactics….something that I lived through and experienced firsthand.
Why is UBiome being investigated?
As a startup, UBiome came into the gut health game with some pretty lofty goals, one of them being to ensure most patients with gut health issues would not need to pay for the company’s clinical testing. However, the company achieved this in a way that wasn’t entirely legal.
UBiome’s doctors order tests online for patients they’ve never met before. When I signed up to take the test for the first time, all I needed to do to get the test sent to me was check a couple of boxes expressing that I suffered from bloating, gas and constipation on the regular. After that, one of UBiome’s doctors ordered the test and sent the bill to my insurance company – from which point on I wasn’t supposed to pay a dime. (If only that had been true!)
Because of its shady prescription procedures, UBiome often did not have the medical evidence it needed to prove to insurance companies that the tests were necessary. As a result, patients like me were sometimes charged thousands of dollars – which becomes even more frustrating, considering the company automatically sent follow-up tests to my house every two weeks. Because I was part of the patient assistance program, I never questioned it – and ultimately believed I was getting this incredible service entirely for free.
As all of this was happened, UBiome was misrepresenting patients’ condition behind-the-scenes by improperly coding for its medical tests so more insurance companies would reimburse them. On one hand, this works out in patients’ favor – and allows the company to make more money. But ultimately, the practice isn’t legal – leading to a fully-fledged FBI investigation.
As of 2019, UBiome’s co-CEOs are on administrative leave, and UBiome is no longer offering clinical testing services. The company still offers its Explorer microbiome testing product, which is a consumer-based product that is not intended as medical advice.