Focused on Risk

I’m often asked by men over 50, “Why did I receive a bill for my colonoscopy if it is considered preventative under Obama-care?” There is a saying among health brokers that goes something like this, “If there is a snip or clip during the procedure it is no longer considered preventative”.

Often during an enrollment meeting, there is a heckler in the crowd that wants to argue over being billed for a recent colonoscopy. Since I am the closest link to the big bad insurance companies, the heckling is generally directed my way. I like to take those opportunities to have a little fun with the person. Since the person was not shy about sharing their experience in front of everyone my response is the following, “You are entitled to a free preventative colonoscopy. Just inform the doctor that if they wish to take a biopsy (snip) or remove a polyp (clip) just wake you up and reschedule the procedure. You have now been given your free preventative colonoscopy and can choose to schedule the follow up procedure that will result in a charge for the removal of a polyp or biopsy”.

Anyone who has ever experienced a colonoscopy knows the experience is one that you do not wish to repeat anytime soon. Most will opt for the one and done.

I found the attached article in The Tennessean this morning that shares a real life story. The lesson from this article is to remember you ‘the patient’ is in control of your own healthcare. Ask questions prior to making your appointment. Let the staff know your wishes prior to treatment. Your insurance company is adjudicating claims based on how the physician or treatment facility codes the claim. If you don’t ask – you won’t know.

To get more information on your health benefits please contact me, Gary Thompson at CS&A Insurance at 615.435.8299 or gthompson@chappellsmith.com.

Gary T Thompson
Employee Benefit Consultant
CS&A Insurance