<p>
</p>
<p>I think that’s probably what you are dealing with. My primary care doc wouldn’t write the order without an (overdue) annual physical. Regulations, you know… He wanted me to get the colonoscopy, not an issue. Just have to follow procedure.</p>
<p>Professionals CAREFULLY try to avoiding tromping on others’ toes, especially if they’re practicing in the same office. All the same, it would be good to call your insurer, just to chck whether you actually need a referral or can self refer for a colonoscopy over the age of 50 (even though this can change if they change the terms of your policy over the years). Knowlege is power, at least to me.</p>
<p>This thread is timely for you:</p>
<p><a href=“http://talk.collegeconfidential.com/parent-cafe/1452864-good-friend-diagnosed-colorectal-cancer.html[/url]”>http://talk.collegeconfidential.com/parent-cafe/1452864-good-friend-diagnosed-colorectal-cancer.html</a></p>
<p>Yes, I had seen that thread (reminded me to call for the appointment, actually). So they got back to me right at the end of the day and okayed it. They are scheduling a few months out, so I can look forward to this in April. :)</p>
<p>One thing we did this time was having H and have our colonoscopies at the same location right after one another. We also try to schedule a great meal we eat together that we enjoy afterwards. Have taken my friend to great lunch when I picked her up as well. Recommend having earliest appointment in morning to minimize dehydration. H sometimes has trouble with them getting I’VE in even dehydrated.</p>
<p>intparent - Glad to hear you got it resolved! Have fun in April!</p>
<p>I had my last colonoscopy during a massive (mid-summer!) power outage. Didn’t affect the hospital. Did affect my home. Our house is on a well, so no electricity mean no running water. Think about it.</p>
<p>Gotta say…I had a 1:00 pm appointment. The prep was done in two parts, both the previous day and the morning of. I was the first appointment after lunch and my friend and I were on our way to lunch by 2:30. I thought the afternoon would be awful, but it really was fine.</p>
<p>My wife nagged(?) the doctors long enough that she not only got colonoscopy, she also got the gastroscopy and the small bowel scope at the same time.</p>
<p>One prep and killed three birds. :)</p>
<p>intparent, make sure it’s covered by your insurance. Not that you shouldn’t have it done regardless, but just to avoid a nasty surprise. My DH also got reminders from Blue Cross that he should have it done. Then after he did, they denied the claim.</p>
<p>dodgersmom, oh dear…</p>
<p>I read that under the new legislation, insurance HAS to cover the screening colonoscopy. We have a very high deductible, but I didn’t have to pay anything for my first colonoscopy. I had a second one recently, for the doctor to confirm he’d completely removed the large polyp, and I believe I will have to pay for it. Seems kind of crazy.</p>
<p>I do NOT recommend making up symptoms to get the dr. to order the test. You will then not be covered under the screening colonscopy. This is currently a big problem, even when patients do go in for a “screening” colonscopy.</p>
<p>Screening ones are supposed to be covered 100%. Many doctors are coding incorrectly (and refusing to fix) and especially coding incorrectly for a screening colonscopy where polyps are incidentally found and removed.</p>
<p>For a high deductible policy, this is a BIG difference…$0 vs $6600. Yes, that is what the hospital, dr., radiologist, anesthesiologist charged my H this fall. What a crock!! I had no idea the extent of this problem until we got stuck with it.</p>
<p>I agree, the preventative screening is covered at 100% but, if while they are in there they take out polyps, they CAN and will charge you for a diagnostic screening. Making up symptoms will automatically make it diagnostic and you will pay for it. It’s a fine line, just make sure they bill it properly. Same with mammograms, fine line there too.</p>
<p>If you are up to date with your annual physicals you should be able to get this done with a phone call. If you are late or behind on your annual physical, you may need to schedule that first and then ask for the referral for the colonoscopy. Generally many docs handle it that way for the mammo referrals, bone density screenings and other “annual” screening tests as well as some prescription refills. Your primary physician should be managing your care and handling any needed referrals. Some people do let those annual physical appointments slide. Many insurance companies discount co-pays or cover co-pays for an annual physical. Do not “make up” symptoms to get this appointment or as SteveMA says you may be charged for something that might be covered as a screening.</p>
<p>I agree, the preventative screening is covered at 100% but, if while they are in there they take out polyps, they CAN and will charge you for a diagnostic screening.</p>
<hr>
<p>Some very lucky folks have employers who write the benefits to allow an annual screening (or however often …) in a way that allows even those that end up requiring extra work (like removing polyps) to be covered 100%. Be very aware that this is the exception and definitely not the norm. As SteveMA correctly points out, it is NOT a good idea to make up reasons to get this test (or a mammogram or other preventive test).</p>
<p>My Anthem policy (and many others from what I found) DO pay if polyps are found and removed during a screening colonscopy. The screening code has to be primary and the polyps a secondary. Many doctors are not doing it correctly, everyone points the fingers somewhere else, it’s the 7th circle of ____ and like usual, the patient is the one taking it.</p>
<p>I’m a little tired of all the media and their “100% coverage” mantra. Medicine is one of the very few products where you are forced to find out the product’s cost <em>after</em> it’s purchased. I’m hoping an end result of all the high deductible policies is that people will question medical providers more before agreeing to everything they suggest and doctors will finally factor in costs instead of being test-happy.</p>
<p>We had colonoscopies (H had 3 and I had 2). We both have had polyps removed sometimes and not others and neither of us has ever been charged more than our co-pay. I believe both screening AND diagnostic colonoscopies are covered in HI, but it’s best for each person to check with insurer.</p>