Ralphie ★ Posted January 10, 2019 Share #1 Posted January 10, 2019 Preventive colonoscopies are covered 100%, right, just like an annual physical? Wrong! Not when they are "diagnostic" as opposed to "preventive", ie if you had polyps removed the last time. So $400 for the testing center and $60 for the doctor. This "coding" stuff sucks! That is definitely how they get you! 1 Link to comment Share on other sites More sharing options...
Randomguy Posted January 10, 2019 Share #2 Posted January 10, 2019 Affordable healthcare is for other people, didn't you know that? 1 Link to comment Share on other sites More sharing options...
maddmaxx ★ Posted January 10, 2019 Share #3 Posted January 10, 2019 Your insurance sucks. 1 1 1 Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 10, 2019 Author Share #4 Posted January 10, 2019 1 hour ago, Randomguy said: Affordable healthcare is for other people, didn't you know that? I just saw where your mayor is getting all you norkers in the city health care! Link to comment Share on other sites More sharing options...
shootingstar Posted January 10, 2019 Share #5 Posted January 10, 2019 2 hours ago, RalphWaldoMooseworth said: Preventive colonoscopies are covered 100%, right, just like an annual physical? Wrong! Not when they are "diagnostic" as opposed to "preventive", ie if you had polyps removed the last time. So $400 for the testing center and $60 for the doctor. This "coding" stuff sucks! That is definitely how they get you! If a person is healthy, most people I know in CAnada only get a colonoscopy every 10 years. We don't get billed at all for this stuff...regardless of age. Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 10, 2019 Share #6 Posted January 10, 2019 2 hours ago, RalphWaldoMooseworth said: Preventive colonoscopies are covered 100%, right, just like an annual physical? Wrong! Not when they are "diagnostic" as opposed to "preventive", ie if you had polyps removed the last time. So $400 for the testing center and $60 for the doctor. This "coding" stuff sucks! That is definitely how they get you! Call where you had it done and tell them if they want paid they need to resubmit it the right way. We have had to do this with several hospitals. Link to comment Share on other sites More sharing options...
petitepedal ★ Posted January 10, 2019 Share #7 Posted January 10, 2019 i would ask them to re-submit too...I had a polip at my first one...the second one is still preventative..just 5 years earlier... 1 Link to comment Share on other sites More sharing options...
2Far ★ Posted January 10, 2019 Share #8 Posted January 10, 2019 I'm due. IIRC, it wasn't anywhere close to being free, but maybe b/c I had an upper scope at the same time?? Link to comment Share on other sites More sharing options...
sheep_herder ★ Posted January 10, 2019 Share #9 Posted January 10, 2019 This sometimes happens with my blood tests, if coded diagnostic it goes toward my deductible, and I pay more out of pocket. This is why I have my labs done at Billings Clinic, Miles City, regardless of the doctor's affiliation. 2 Link to comment Share on other sites More sharing options...
Popular Post Square Wheels Posted January 10, 2019 Popular Post Share #10 Posted January 10, 2019 Sounds like they really cleaned you out. 1 3 3 Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 10, 2019 Author Share #11 Posted January 10, 2019 Thanks, longjohnn and others. Just like with Comcast and others, you have to watch your wallet at all times! Link to comment Share on other sites More sharing options...
team scooter Posted January 10, 2019 Share #12 Posted January 10, 2019 My wife's colonoscopy story. She's been harping on me to go get one. So last summer she went and got her colonoscopy first to show me how simple and painless it was. All went well. But a week later when she went for her scheduled breast exam, they found an abnormality, so they sent her for more tests. They concluded she had a large dark lump near her armpit. With her history, they quickly shuffled her in for a biopsy. At first they didn't say it was cancer, but they never said it wasn't either. For weeks it was touch and go. After all was said and done, and after they rang up over $100,000 in bills to her insurance, they figured out the IV they used during the colonoscopy caused one of her lymph nodes to enlarge and turn dark. Nothing had to be done, it later fixed itself. Anyway, that's my story of why I'm a fraidy cat to get a colonoscopy. 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 10, 2019 Share #13 Posted January 10, 2019 We have hospital systems that are always getting it wrong and others that always get it right. I guess not enough people complain when they code it wrong. Link to comment Share on other sites More sharing options...
Razors Edge ★ Posted January 10, 2019 Share #14 Posted January 10, 2019 6 hours ago, RalphWaldoMooseworth said: That is definitely how they get you! How who gets you? Link to comment Share on other sites More sharing options...
MickinMD ★ Posted January 10, 2019 Share #15 Posted January 10, 2019 6 hours ago, RalphWaldoMooseworth said: Preventive colonoscopies are covered 100%, right, just like an annual physical? Wrong! Not when they are "diagnostic" as opposed to "preventive", ie if you had polyps removed the last time. So $400 for the testing center and $60 for the doctor. This "coding" stuff sucks! That is definitely how they get you! I guess it depends on the insurance. The Carefirst-BCBS insurance that was my primary insurance throughout my teaching career and is my supplementary to Medicare since age 65 covers all tests 100%. So I've had a colonoscopy, three days of heart tests (checkups, not for a problem) before taking up cycling for exercise, electrocardiogram and special blood sugar and other tests before my 2017 shoulder surgery, every-three-month blood tests for diabetes, etc. and haven't paid a cent for any of them. My guess is that BCBS figures teachers tend to follow doctors orders and take better care of their health than average and so the tests result in less hospitalization costs, etc. for BCBS. Link to comment Share on other sites More sharing options...
jsharr ★ Posted January 10, 2019 Share #16 Posted January 10, 2019 I got mine from two guys in an alley for $20. They both had lab coats and rubber gloves, so it seemed legit at the time. 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 10, 2019 Share #17 Posted January 10, 2019 8 minutes ago, MickinMD said: My guess is that BCBS figures teachers tend to follow doctors orders and take better care of their health than average and so the tests result in less hospitalization costs, etc. for BCBS. Or that teachers unions demand quality insurance. I never had to pay for any testing when I was working but my Medicare advantage sucks. It’s only an advantage for the insurance companies. Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 10, 2019 Author Share #18 Posted January 10, 2019 Yeah, the whole idea of preventive care is to prevent much more expensive remedial care so that is why they subsidize it. But I guess they just can't resist nickel and diming. And by nickel and dime I mean $500 and $1000! 1 Link to comment Share on other sites More sharing options...
maddmaxx ★ Posted January 10, 2019 Share #19 Posted January 10, 2019 1 hour ago, jsharr said: I got mine from two guys in an alley for $20. They both had lab coats and rubber gloves, so it seemed legit at the time. Nono. That was for prolapse, not polyps. 1 Link to comment Share on other sites More sharing options...
Neil Young Posted January 10, 2019 Share #20 Posted January 10, 2019 2 hours ago, Myself said: Sounds like they really cleaned you out. NOMINATED! 2 Link to comment Share on other sites More sharing options...
BuffJim Posted January 10, 2019 Share #21 Posted January 10, 2019 I get to experience this joy again on Monday. Woohoo! 1 Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 11, 2019 Author Share #22 Posted January 11, 2019 Here we go - looks like it is a thing. I guess I can see that since I had to go back in 3 vs 5 years that costs a lot more. https://www.stopcoloncancernow.com/spread-awareness/news/what-is-the-difference-between-screening-and-diagnostic-colonoscopy Link to comment Share on other sites More sharing options...
Scrapr ★ Posted January 11, 2019 Share #23 Posted January 11, 2019 1 minute ago, RalphWaldoMooseworth said: Here we go - looks like it is a thing. I guess I can see that since I had to go back in 3 vs 5 years that costs a lot more. https://www.stopcoloncancernow.com/spread-awareness/news/what-is-the-difference-between-screening-and-diagnostic-colonoscopy early am out here & I read that as screaming and not screening ouchie....I flinched a little 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 11, 2019 Share #24 Posted January 11, 2019 9 minutes ago, RalphWaldoMooseworth said: Here we go - looks like it is a thing. I guess I can see that since I had to go back in 3 vs 5 years that costs a lot more. https://www.stopcoloncancernow.com/spread-awareness/news/what-is-the-difference-between-screening-and-diagnostic-colonoscopy Sounds like bullshit to me. Medicare supliment covers everything, no co-pays or deductible, Medicare advantage rapes you for every doctor visit and procedure. I should pay my broker a visit and tell her what I think of her.? 1 Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 11, 2019 Author Share #25 Posted January 11, 2019 2 minutes ago, Longjohn said: Sounds like bullshit to me. Medicare supliment covers everything, no co-pays or deductible, Medicare advantage rapes you for every doctor visit and procedure. I should pay my broker a visit and tell her what I think of her.? Sounds just like taxes - obfuscation by complication. 1 Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 11, 2019 Share #26 Posted January 11, 2019 5 minutes ago, RalphWaldoMooseworth said: Sounds just like taxes - obfuscation by complication. But not for the broker, they should know these things, intentional screwing you over. Link to comment Share on other sites More sharing options...
Ralphie ★ Posted January 11, 2019 Author Share #27 Posted January 11, 2019 2 minutes ago, Longjohn said: But not for the broker, they should know these things, intentional screwing you over. Do you think there was something in it for her? Why would she do that? Link to comment Share on other sites More sharing options...
Longjohn ★ Posted January 11, 2019 Share #28 Posted January 11, 2019 1 minute ago, RalphWaldoMooseworth said: Do you think there was something in it for her? Why would she do that? Obviously they get commission plus probably kickbacks. There is really no reason I can see for the advantage plans to exist other than to take advantage of the elderly. Link to comment Share on other sites More sharing options...
donkpow Posted January 11, 2019 Share #29 Posted January 11, 2019 That's no problem. I tell them I am addicted to propofol. Not only do I get the colonoscopy for free, I get several visits with a counselor, a month's room and board, and a bottle of mild narcotic like drugs. 1 Link to comment Share on other sites More sharing options...
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