People who have undergone or have been recommended to undergo an optical colonoscopy may receive up to four bills for the facility, doctor, anesthesiology, and pathology (if a polyp was removed for analysis).
Even though the actual exam itself is covered in full by health insurance as part of the Affordable Care Act, other aspects of the screening exam are often not. This may come as a surprise to many who make the incorrect presumption about all aspects of an optical colonoscopy being covered in full.
That’s where the benefit – a financial benefit that could end up in the hundreds of dollars or more – comes into play.
One person’s experience
In 2012, one man was recommended by his primary care provider to undergo an optical screening colonoscopy. He was over the age of 50 and had never had one previously as part of his medical history. As with the above narrative, he presumed that with the Affordable Care Act in place, this screening would come at no cost to him.
Unfortunately, he found out differently.
First, came the usual insurance benefits statements that include lots and lots of charges and big numbers, which don’t mean much of anything because insurance coverage kicks in and works its “magic” to reduce numbers based on agreed upon reimbursements to the medical providers. Then, came the actual bills.
Yes.. bills.. as in plural.
What was not covered?
First came the bill from the aesthesiologist. Then came the bill from the gastroenterologist. Then came the bill from the endoscopy center where the colonoscopy was performed.
This added up to hundreds of dollars in healthcare costs that were not discussed by any medical providers prior to the test.
At Diagnostic Imaging Services, a screening CT colonography is performed the same way all of our other tests are — one fee and price covers everything we do. There’s no other charges or fees.
A screening Virtual CT Colonography is covered by most health insurance plans, with the exception of Medicare and Managed Medicare plans. The age requirement to undergo this screening is 50 years of age or above.
Many people can opt for the convenience and the financial benefit of a screening CT colonography at Diagnostic Imaging Services. Click here to learn more about this screening exam performed currently at our Metairie – Veterans Memorial Boulevard center.
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