4 ms·

You are complaining about the rare situation where someone gets fecal scanning first (and I agree this leads to perverse incentives)... But here's what the real

by gregw2 4y ago

You are complaining about the rare situation where someone gets fecal scanning first (and I agree this leads to perverse incentives)... But here's what the real racket is... American healthcare considers the colonoscopy preventative so the exam is covered... but if they see even a single polyp and decide to cut it off to get checked whether it is benign or not, that is not preventative but is diagnostic and thus is not covered and costs you $$$ in copays.

seanmcdirmid 4y ago
Huh. I didn’t see that in my exam. They did a biopsy on one polyp, but I wasn’t charged for it.
- hef19898 4y ago
  Hope results were of the non-worrisome kind!
  - seanmcdirmid 4y ago
    Nah, it all sounded really standard. I think 45 is a bit too young for the test, but it wasn't a bad experience at all besides getting completely hammered by the laxative. Next time I'll ask for anti-nausea medication.
cmurf 4y ago
That's what my provider told me too. However: https://www.npr.org/sections/health-shots/2022/05/31/1101861735/colonoscopy-cost-cancer-screening https://www.npr.org/sections/health-shots/2022/05/31/1101861...
astura 4y ago
They aren't supposed to do this - See the link I posted on a sibling comment https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-coverage-laws.html https://www.cancer.org/cancer/colon-rectal-cancer/detection-... >Soon after the ACA became law, some insurance companies considered a colonoscopy to no longer be just a ‘screening’ test if a polyp was removed during the procedure. It would then be a ‘diagnostic’ test, and would therefore be subject to co-pays and deductibles. However, the US Department of Health and Human Services has clarified that removal of a polyp is an integral part of a screening colonoscopy, and therefore patients with private insurance should not have to pay out-of-pocket for it (although this does not apply to Medicare, as discussed below).

by gregw2 4y ago

seanmcdirmid 4y ago

Huh. I didn’t see that in my exam. They did a biopsy on one polyp, but I wasn’t charged for it.

hef19898 4y ago
Hope results were of the non-worrisome kind!
- seanmcdirmid 4y ago
  Nah, it all sounded really standard. I think 45 is a bit too young for the test, but it wasn't a bad experience at all besides getting completely hammered by the laxative. Next time I'll ask for anti-nausea medication.

cmurf 4y ago

That's what my provider told me too. However: https://www.npr.org/sections/health-shots/2022/05/31/1101861735/colonoscopy-cost-cancer-screening https://www.npr.org/sections/health-shots/2022/05/31/1101861...

astura 4y ago

They aren't supposed to do this - See the link I posted on a sibling comment https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/screening-coverage-laws.html https://www.cancer.org/cancer/colon-rectal-cancer/detection-... >Soon after the ACA became law, some insurance companies considered a colonoscopy to no longer be just a ‘screening’ test if a polyp was removed during the procedure. It would then be a ‘diagnostic’ test, and would therefore be subject to co-pays and deductibles. However, the US Department of Health and Human Services has clarified that removal of a polyp is an integral part of a screening colonoscopy, and therefore patients with private insurance should not have to pay out-of-pocket for it (although this does not apply to Medicare, as discussed below).