I am 31 years old and high risk for colon cancer (my mom had colon cancer at age 42, so did my aunt, multiple family members with precancerous polyps and a personal history of 3 precancerous polyps) and for that reason my GI and PCP recommended I get preventative colonoscopies every 3-5 years.
I had one in Sept and got slapped with an almost $3,000 bill, I have had them before and owed nothing (in fact I was refunded $350 for a prepayment fee)
I called the Dr's office and the billing person was completely rude, told me I was irresponsible for not knowing my plan (I do know it) and then laughed at me on the phone when I told her I had to end the call (she was so rude she sent me into a panic attack and I could hardly speak). She told me that I can get 1 colonoscopy every 10 years no matter what the doctor says and basically my options are to pay a huge bill or get cancer.
I did 6 hours of research and I found Aetna's policy which says that average risk people can start getting colonoscopies at age 45 and are allowed 1 every 10 years and that high risk people like me are allowed 1 every 2 years as needed (my last one was 5 years ago, also I already knew this but the rude lady acted like I was an idiot when I tried to explain this to her).
So I call Aetna and find out that the Dr coded me as a diagnostic colonoscopy instead of preventative and they neglected to code me as high risk (I am assuming Aetna's policy does not cover diagnostic since I was charged. also, I had no signs or symptoms of any colorectal issues I only went because I was told I had to by the Dr, I happened to get diagnosed with diverticulitis but no diagnostic testing was done on that to my knowledge ).
I did have 3 polyps removed/biopsies but I also had that done 3 years ago and was not charged because I am high risk. These were sent to an outside lab and I can see a claim for that and Aetna paid for it.
Does anyone know if I should be responsible for this bill, I have talked to 6 different people at Aetna and everyone gave me a different answer so idk what to do.
Can anyone offer advice? I lost my job due to covid and had to take on credit card debt to cover food and bills, I have student loans, a mortgage and a car payment and I cannot afford $3,000 for something that I thought was covered by insurance that my insurance covers according to the policy online.
What am I supposed to, pay a bill I can't afford every 5 years or wait until I get a polyp big enough for them to diagnose me with cancer and wait to get 2 ft of my colon removed like my mom?
Submitted December 07, 2020 at 11:47PM by Affectionate_Trash89 https://ift.tt/2Iw0KgM
