Many insurance policies DO NOT cover routine or screening colonoscopies. A past medical history or family history of either colon polyps or colon cancer is not considered "routine" by most insurers.
Medicare will cover only one routine screening colonoscopy every ten years. If you have past medical and/or family history, colon screenings are covered every 24 months.
Every endoscopy procedure scheduled for the GI Diagnostic Center, is pre-certified for insurance eligibility and benefits. In most cases both routine and medical benefits are obtained from your insurance policy according to your diagnosis. Once all insurance information is obtained, you will receive a call regarding your estimated fee for the service being rendered at the GI Center. This is ONLY for the facility charges.
The physician will bill separately for your procedure and cannot pre-certify. The only information they have about your scheduled procedure is a CPT code range and tentative diagnosis as given to them by your primary care physician. You should call your insurance company to find out what they will pay toward your physician bill so you are prepared for the total of both facility and physician charges.
If you do not have medical insurance, you can call Medical Eligibility & Counseling Services (MECS) at 237-3205 to speak with someone about financial assistance.