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RazzleCat

(732 posts)
Wed Aug 19, 2020, 04:27 PM Aug 2020

Yet another stupid insurance issue, this is so bad

Another cry for single payer. Just got a late bill, that I did not remember ever seeing prior. Small bill $50.00, but did not recognize the provider. Go to my insurance web site, see a bill for the exact same amount, but again different provider. Neither the bill, or web site gave the date of service, or an “English” translation of what it was. Call the provider to inquire, when and what. Well it was a mammogram follow up (its all good). Here come my questions.

I had this done at X so why a bill from Y. Well the radiologist we used was out of network.

My next question. This is part of well woman, so why is it not covered that way. Well she (your Doctor) ordered just a B procedure/image. Me, I had a mammogram, yes but she only wanted the B angle on your right breast, so its not a well woman mammogram, it is a separate test. A mammogram would be A,B,C,D,E images of both breasts. Me, so what your saying is if I had had a full series of images of both breasts, rather than just a few images of one breast from a specific angle it would be covered. An image that would have be captured in any regular mammogram? In other words if I had a full series, used up more of the tech’s time, used more computer memory (digital images), used more energy and time on the machine causing it to need maintenance sooner, it would be covered, but because only one image (the iffy one from my prior visit), was requested I get to pay. The answer was yes. So what have I learned, if this happens again, to waste everyones time and money and get the full set of images done to save me $50.00. This is such a waste of everyones time and MONEY.

5 replies = new reply since forum marked as read
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Yet another stupid insurance issue, this is so bad (Original Post) RazzleCat Aug 2020 OP
The yearly well-woman mammogram is Phoenix61 Aug 2020 #1
follow up images are not Skittles Aug 2020 #2
I'm happy they cover the digital ones now. Phoenix61 Aug 2020 #3
that's great Skittles Aug 2020 #4
Insurance ClaudiaBradley Oct 2020 #5

Phoenix61

(16,951 posts)
1. The yearly well-woman mammogram is
Wed Aug 19, 2020, 04:37 PM
Aug 2020

covered at 100%. Any follow-up, which you said this was, is going to be subject to an office visit charge.

Skittles

(152,964 posts)
2. follow up images are not
Wed Aug 19, 2020, 04:41 PM
Aug 2020

heck, I was charged over 700 bucks for "better images" - insurance discounted it to 500 bucks....seems to me like, if they don't see what they need to see from the original images that means they did not do them right and need to REDO FOR FREE

SCAM

Phoenix61

(16,951 posts)
3. I'm happy they cover the digital ones now.
Wed Aug 19, 2020, 04:47 PM
Aug 2020

I’m super lucky and go to an excellent facility. They caught breast cancer at stage 1. My surgeon looked at the films and said the radiologist was really good and that he wouldn’t have caught it.

Skittles

(152,964 posts)
4. that's great
Wed Aug 19, 2020, 05:30 PM
Aug 2020

I will request digital images next time; that wasn't the first time they had to "re-do" mine. Thank you.

ClaudiaBradley

(2 posts)
5. Insurance
Mon Oct 12, 2020, 12:46 PM
Oct 2020

the same problem with insurance, I'm looking for a reliable place where to issue it quickly and inexpensively.

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