Couple Charged $600 Each for ‘Surgical Trays’ Even Though Their Colonoscopies Were Free and Covered by Insurance

• Chicago couple Chantal Panozzo and Brian Opyd received routine preventive colonoscopies that were free under the Affordable Care Act
• Because of a loophole in the law, they still charged them $600 for “surgical trays”
• Panozzo contested the allegations by filing a complaint and wrote to her elected officials claiming consumers were being “taken advantage of”

An Illinois couple is speaking out after a provider charged them $600 each for “surgical trays” after routine preventive colonoscopies. After insurance was applied, each patient received a $250 bill.

Chantal Panozzo, 46, and husband Brian Opyd, 45, both scheduled colonoscopies after reaching the recommended age of 45. The exam, performed by the Illinois Gastroenterology Group, would cost $2,034 before any discounts or insurance discounts.

However, under the Affordable Care Act, the couple – who live in Chicago and are covered by Blue Cross and Blue Shield of Illinois – should have received the service for free. Their insurance company would be responsible for paying the remaining costs of the examination.

The Affordable Care Act requires that preventive care services such as colonoscopies, mammograms and cervical cancer screenings be fully covered at no cost to patients.

“This was our opportunity to get free preventive care,” Panozzo told NPR, noting that their findings had normalized.

However, there is a loophole where health care providers can still bill for any goods or services they choose to list, as long as they adhere to the insurance contract for the preventive service.

The FDA has approved a new preparation for colonoscopy that tastes like a sports drink

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So, despite the free exam, the couple later received their bills for the visit and were surprised to find they had each paid $600 for “surgical supplies.” Their insurer explained that the codes were for “surgical trays”. The couple eventually appealed and did not have to pay.

“The insurance company should pay the full amount of the claim, but there’s no requirement that the provider properly code the claim,” Sabrina Corlette, co-director of the Center for Health Insurance Reform at Georgetown University, told NPR.

The GI Alliance, the national group that governs the Illinois Gastroenterology Group, has not yet responded to PEOPLE’s request for comment.

In addition to disputing the charges by filing a complaint with her insurer, Panozzo filed a complaint with the Illinois Department of Insurance. She also wrote to her elected officials claiming that consumers are being “exploited” and “stolen.”

She was relieved when the insurance later approved the appeal and neither she nor her husband had to pay the costs.

But Panozzo said she still feels defeated and exhausted after all the ordeal. She admitted that she has little faith in the American health care system, even though she has lived abroad for almost 10 years.

“I could function better in the health system in German than here in English,” she said.

The American Cancer Society recommends that adults age 45 and older get regular colon cancer screenings. They also urge people with symptoms of colon cancer — such as changes in bowel movements, including increased diarrhea, rectal bleeding, dark stools and unexpected weight loss — to see a doctor.

Earlier and more frequent screenings are also recommended if someone has inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), or a personal or family history of colon cancer or colorectal polyps, among other preexisting conditions.

Categories: Trends
Source: HIS Education