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Colonoscopy, Insurance, More $

July 22, 2009

More aggravation than anything, but another example of what’s wrong with the insurance industry. (Yes, I was very satisfied with how the c-scope went, the clinic, and very happy everything was okay. That’s not what this is about.)

My employer recently changed insurance providers, much to my doctor’s happiness. CIGNA was who it was at the time of my colonoscopy. I received an additional bill for $40.00 from the clinic that did the procedure.

Here was the process:

  1. Initial visit $40
  2. Day of procedure: $120

That was supposed to take care of everything on my part. However, on the day that I received the additional bill from the clinic, I received an “Explanation of Medical Benefits” from Cigna. The total charge for the procedure was around $1,400. There was nothing unusual about the procedure, no added medication, surgery, etc. Everything had been cleared through the referral process (and this was a test that CIGNA was encouraging me to have because of my age). So a month after the fact, I’m told that my plan liability was a little more than $200, and I’m responsible for another $40.

Now this might not seem like much to you, but to me that’s like going to buy a pair of jeans and they’re marked $40, which you pay; then after you’ve left the store, you get a call saying that you owe an additional $20 for.

Shouldn’t the cost be the cost? The patient liability be all settled ahead of time? I’m going to pay it, of course.I can appeal, but if it goes anything like appealing my traffic ticket did, it would wind up costing me more.

Oh, and you saw where there were an additional 5 million who lost their insurance; which brings the number of Americans without insurance to over 50 million. I hope you aren’t one of them.

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