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PSA: Delta insurance doesn't cover skin exams

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Old 01-07-2020 | 05:08 PM
  #11  
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Totally appreciate this heads up(no sarcasm, as is usual with me)....this is really good info.

BTW, if you get a colonoscopy(preventative, 100% covered)...they will root around until they can excise a polyp. Make sure when you get another one (3-5 years later) it's not gonna be billed/coded as diagnostic/retreatment/cancer removal etc....it should still be billed as preventative....therefor 100% covered
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Old 01-07-2020 | 05:15 PM
  #12  
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Originally Posted by Buck Rogers
Totally appreciate this heads up(no sarcasm, as is usual with me)....this is really good info.

BTW, if you get a colonoscopy(preventative, 100% covered)...they will root around until they can excise a polyp. Make sure when you get another one (3-5 years later) it's not gonna be billed/coded as diagnostic/retreatment/cancer removal etc....it should still be billed as preventative....therefor 100% covered
My experience: Sure the colonoscopy was preventative and is covered. And yes the facility was in-network. And yes the gastroenterologist was in network. But the hose he used was out of network so you’ll have to pay $500 for that. And the Tylenol was $100.

Our entire health care system needs to be torn down and rebuilt from scratch.
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Old 01-07-2020 | 08:35 PM
  #13  
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Originally Posted by GogglesPisano
My experience: Sure the colonoscopy was preventative and is covered. And yes the facility was in-network. And yes the gastroenterologist was in network. But the hose he used was out of network so you’ll have to pay $500 for that. And the Tylenol was $100.

Our entire health care system needs to be torn down and rebuilt from scratch.
I'd be a little concerned about the hose thing.
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Old 01-08-2020 | 06:55 AM
  #14  
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Originally Posted by GogglesPisano
My experience: Sure the colonoscopy was preventative and is covered. And yes the facility was in-network. And yes the gastroenterologist was in network. But the hose he used was out of network so you’ll have to pay $500 for that. And the Tylenol was $100.

Our entire health care system needs to be torn down and rebuilt from scratch.
Ran into that for a surgery also a couple of years ago. Thought everything was in-network but turns out the hospital contracts anesthesia services through a separate company, and they were out of network. Not sure how we would have possibly known that. To be fair, probably wouldn't have changed our minds about where we had the surgery, but did make it more expensive.
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Old 01-08-2020 | 07:01 AM
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Originally Posted by badflaps
I'd be a little concerned about the hose thing.

Hose/Cable. I think the camera's on the end.
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Old 01-08-2020 | 07:03 AM
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Originally Posted by QuirkyJules
Ran into that for a surgery also a couple of years ago. Thought everything was in-network but turns out the hospital contracts anesthesia services through a separate company, and they were out of network. Not sure how we would have possibly known that. To be fair, probably wouldn't have changed our minds about where we had the surgery, but did make it more expensive.
Welcome to the American health care scam.
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Old 01-08-2020 | 07:39 AM
  #17  
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Originally Posted by GogglesPisano
Welcome to the American health care scam.
Yep, it's turning into a shell game. Try to find the Out of Network charge - it's in there somewhere!
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Old 01-08-2020 | 11:54 AM
  #18  
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Originally Posted by iaflyer
Yep, it's turning into a shell game. Try to find the Out of Network charge - it's in there somewhere!
I had an arthroscopic knee surgery years ago at an out patient surgery place. They called me the night before surgery at 4:30pm to tell me they “are out of network, but bill as ‘in network’” if that makes any sense. They said the surgery was going to be an extra $500 I had to bring in with me the next day.

My wife’s friend works in insurance and told me that they did that on purpose. They knew I had already taken the time off for surgery and was mentally prepared, and they were banking on me not wanting to cancel the surgery at that point.
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Old 01-30-2020 | 05:48 AM
  #19  
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Just as a follow-up to this issue, I saw the dermatologist a week ago for an annual exam and asked them to code it that way. I got the bill and it simply said it was an "office visit". After calling the clinic's billing office and getting no help, in fact, getting told that an annual exam wasn't a thing and that they had no codes for it, I called the insurance company(UHC). The lady I spoke with was very helpful and simply took care of it right away. I guess since it's a new benefit, Delta has told UHC to pay for the exam but you'll probably have to call UHC to get it done. Until the dermatologists have the appropriate codes, we'll likely have to make this extra call. Clunky but effective.
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Old 01-30-2020 | 07:51 AM
  #20  
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I get one every year and it’s covered..
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