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Post by shanniebananie on Jan 2, 2020 21:12:58 GMT
So, I am scheduled for a colonoscopy tomorrow morning. I received a call on Tuesday with the general intake questions. Nothing was mentioned about insurance. Today, I received an email saying that the procedure will not be covered by insurance and that I will need to pay out of pocket - up to $5500. Huh?? The reason is I am under 50. Yes, I am under 50 but my mother also had stage 3 colon cancer. I had a colonoscopy five years ago and, according to my general doctor, I am due for another.
I have called both my general doctor (said they just called over the referral and noted family history) and the doctor doing the procedure. According to my general doc, it is up to the procedure doc whether it is considered a screening or diagnostic. BUT, THEY ARE NOT ANSWERING THEIR PHONES! Have left 3 messages. No message that they are not open today or anything. The billing department also tried to call and there was no answer.
I am 6 months away from being 50 and have no symptoms, so of course I can wait. But there is no one answering to reschedule!! I could not show up and get charged a cancellation fee, but that doesn't seem right.
So I am going to do the prep and hope we can get it cleared up tomorrow, but I am almost positive I am going to show up tomorrow and they are going to say it is not covered.
This sucks!
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brandy327
Drama Llama
Posts: 6,353
Jun 26, 2014 16:09:34 GMT
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Post by brandy327 on Jan 2, 2020 21:37:52 GMT
I'd go and have it done and fight the insurance after. I had my first colonoscopy at 40 due to my dad passing from colon cancer at the age of 51. I go again in 2 years next one. It's pretty common practice so I'm sure it would be covered. I didn't have to pay anything for mine at 40.
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Post by librarylady on Jan 2, 2020 21:41:01 GMT
Call your insurance company and see if they can get a response from the dr.
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Post by PolarGreen12 on Jan 2, 2020 21:45:18 GMT
If the doc is recommending it because of previous history it will pay. Someone isn’t looking at the records correctly. I have to get ultrasounds of my throat every year, this summer they didn’t pay at first because they said I had no reason to have that diagnostic procedure done. I guess thyroid cancer wasn’t obvious to them. When I told her to look at my last two years of history she shut up pretty quick and took care of it. 🤦🏻♀️
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Post by Linda on Jan 3, 2020 0:18:13 GMT
Sympathy - I ended up paying out of pocket for mine - the insurance company was willing to pay but the dr had to code it as a screening colonoscopy and he coded it as diagnostic and wouldn't change it (for the record - no symptoms except a family history). They called me this year to suggest it was time for another one - I'm waiting until next year when I'll be 50 and I'll be seeing someone else.
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Post by scrapmaven on Jan 3, 2020 0:40:15 GMT
They might be off today. That sucks, because if you go through the torture of prepping then they should at least do the procedure I'll cross my fingers that you are able to have the procedure and that it comes back w/normal results.
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momto4kiddos
Drama Llama
Posts: 5,151
Jun 26, 2014 11:45:15 GMT
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Post by momto4kiddos on Jan 3, 2020 0:59:35 GMT
I hate that they wait until last minute to figure out that they may or may not cover things!! I had a colonoscopy schedule at 49 due to anemia and family history. The nurse called because they used family history and unless it's a parent it wasn't covered...she asked if there was any other reason and once I said anemia she said they'll cover that!
Few months later I had another scheduled at a city hospital and they called and said my insurance wouldn't cover for another reason...that one had to be rescheduled when the insurance sorted it all it. Completely frustrating, but at least it was never the day before when it was prep time.
Hoping that you are able to move forward with it tomorrow without any issues.
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