Patients Surprised by Bizarre Charges for Routine Colonoscopies Though Insurance Expected to Cover Entire Procedure

CHICAGO, IL – Chantal Panozzo and her husband expected their first routine colonoscopies to be fully covered by insurance as preventive care under federal law. However, after following their primary care doctors’ orders and scheduling their screenings, the bills that followed left them blindsided. This caught the couple off guard, particularly because they pay over $1,400 each month for insurance through the state’s health insurance exchange. Panozzo and her husband run a business out of their suburban home near Chicago, making the unexpected bills particularly unwelcome.

By law, preventive services, including routine colonoscopies, are supposed to be available at zero cost to patients. However, Panozzo and her husband’s experience highlighted a loophole in this regulation. Despite their results coming back normal, the couple received hefty bills, including a $600 charge for each patient that their initial insurance documents did not clarify. This left them each with a $250 bill, applied to their deductibles.

According to Panozzo, insurers are supposed to cover the full cost of preventive care, but providers may bill patients for additional charges as long as they adhere to their contracts with insurance. In this case, the insurance documents showed that each patient was responsible for a portion of the $600 charges, which the provider identified as “surgical trays.”

Panozzo contested the bills, filing appeals with her insurer and lodging a complaint with the Illinois Department of Insurance, ultimately resulting in BCBS approving both appeals. However, the experience left her feeling defeated and distrustful of the American healthcare system, especially given her experience living abroad.

This situation exposed the broader issue of how medical providers bill for care and the lack of recourse for patients under federal law. It highlights the potential impact of private equity ownership in medical practices and the need for insurers to crack down on such billing practices to protect patients from unexpected charges for preventive care.

Overall, Panozzo’s experience sheds light on the complexity and potential pitfalls of the U.S. healthcare system, leaving patients feeling helpless and discouraged in their efforts to navigate billing inconsistencies.