Diagnostic mammogram copayment

Mamasha
Mamasha Member Posts: 104
edited April 2019 in Employment, Insurance, and Other Financial Issues

hello,

So I was hit with $500 copayment because mammogram was diagnostic not preventative which is covered 100%. I’m two years out This was just yearly exam nothing they found that required looking for something just Dana schedules these yearly. Should I just ask for a preventative going forward or is there anyway around paying the copayment

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Comments

  • Salamandra
    Salamandra Member Posts: 1,444
    edited April 2019

    Contact your hospital. They may be able to re-process this one. It's worth discussing with them.

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  • vlnrph
    vlnrph Member Posts: 1,632
    edited April 2019

    This sounds like a coding error. Amazing how many times these occur. It *should* be an easy fix...

    Call and tell the billing office that you had a screening mammogram and that they should resubmit the claim to your insurance. Let us know how they respond!

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  • Mamasha
    Mamasha Member Posts: 104
    edited April 2019

    I don't know once you have breast cancer is a diagnostic mammogram always requested going forward? Last year I probably hit my deductible so I didn't realize that I'm on the hook for this exam. I thought it was just my yearly but learned the hardway it cost $430

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  • MelissaDallas
    MelissaDallas Member Posts: 7,268
    edited April 2019

    I don't think it is a coding error. For certain periods of time after a surgery or treatment some doctors want diagnostic with more views instead of screening.

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  • Salamandra
    Salamandra Member Posts: 1,444
    edited April 2019

    If the copayment is a hardship for you, maybe you can get help from one of the organizations that does financial help for breast cancer patients. Googling brought up the Bern Foundation, but there may be others too. If there is social work support at your cancer center, they may be able to help you find sources of help. The billing office might also be able to work with you on a payment plan, if that would make a difference.

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  • edwards750
    edwards750 Member Posts: 3,761
    edited April 2019

    I always get a diagnostic mammogram. I want to know before I leave the hospital plus my mother had BC so I have the high risk category to deal with too.

    I definitely would have them re-code it if you didn’t have one. I’ve had my doctor do that before

    Diane

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