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PSA: Delta insurance doesn't cover skin exams
Late last year, Delta claimed in 2020 our insurance would cover annual skin exams. Sooo, I just left the dermatologist and was billed $110. They said it's considered diagnostic and not preventive.....
Our insurance only covers preventive. |
I plan on going this month, so I am looking into this. I also thought it was 100% covered and that's what it stated in open enrollment. I am contacting UHC. Are you sure they just didn't code it wrong?
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To be clear, I am going in for a preventative skin check, did you do something different?
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I just checked with UHC, it is 100% covered if it is a preventative check. You may have just had it coded wrong.
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When I called to make an appointment...I clearly stated a preventative skin exam. The office said that all dermatologists will code these preventive exams as diagnostic which is NOT covered 100%.
This was in Newnan, GA and they said they do a lot of pilots, so I'd imagine many others will experience the same issue. FYI...Skin Cancer Specialists ....Newnan |
Update....the problem lies with that particular office. I'll have to take it up with them.
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Originally Posted by 4BlueBars
(Post 2952882)
When I called to make an appointment...I clearly stated a preventative skin exam. The office said that all dermatologists will code these preventive exams as diagnostic which is NOT covered 100%.
This was in Newnan, GA and they said they do a lot of pilots, so I'd imagine many others will experience the same issue. FYI...Skin Cancer Specialists ....Newnan |
Just did my annual one today, was covered.
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I've been to the "Mark and Gouge" to the tune of $80-$100,000, no complaints.
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I get one every year and its covered..
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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 |
Originally Posted by Buck Rogers
(Post 2953253)
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 Our entire health care system needs to be torn down and rebuilt from scratch. |
Originally Posted by GogglesPisano
(Post 2953256)
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. |
Originally Posted by GogglesPisano
(Post 2953256)
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. |
Originally Posted by badflaps
(Post 2953322)
I'd be a little concerned about the hose thing.
Hose/Cable. I think the camera's on the end. |
Originally Posted by QuirkyJules
(Post 2953438)
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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Originally Posted by GogglesPisano
(Post 2953440)
Welcome to the American health care scam.
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Originally Posted by iaflyer
(Post 2953465)
Yep, it's turning into a shell game. Try to find the Out of Network charge - it's in there somewhere!
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. |
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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I get one every year and it’s covered..
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