Colonoscopy sketchiness around billing, double billing codes and possible false claim they removed a polyp but didn’t

I had a bad feeling about going with my gastroenterologist for my colonoscopy. I considered finding another but he had good reviews and I didn’t want to wait another 1-2 months seeing a whole new gastroenterologist then booking a 2nd appointment for the colonscopy.

He seemed more concerned about making money than my care/wellbeing even before the procedure, he kept asking me questions about what I do for a living which would’ve been fine smalltalk but he asked multiple times across multiple appointments before the colonoscopy, which started giving me the impression he was trying to assess my finances rather than my condition. When I asked why he would only do a colonoscopy and not a “double” (colonoscopy + upper endoscopy same day) because I was having stomach concerns as well he flat out said “I’m concerned you’re not going to pay me”. I should’ve gone with another doctor just from that interaction alone but I was having enough issues with rectal bleeding that I just wanted to know without further delay if there was something wrong. So I went through with it.

Well the insurance claim is now showing in my insurance website “Claims History & Explanation Of Benefits (EOBs)” and it’s showing 2 codes for the exact same thing “Colonoscopy W/lesion Removal” and “Colonoscopy And Biopsy”. Isn’t a lesion removal the same as a biopsy? Further, they have the same code number 00066/00067. So I’m paying $378 instead of $303 (if it was only line 1) or $74.69 (if it was only line 2). It’s like their billing department was looking for how to bill the most amount of the insurance without any regard to what I would also be charged from the co-insurance. That’s not including the $125 anesthesia ($3k billed to the insurance).

What’s even more sketchy about this is when I woke up from the procedure the nurse even told me there was no polyps found, i.e. no biopsy. I mentioned this to the doctor when he came over to me and then he walked the nurse over to the other side of the room and it seemed like he was scolding/”correcting” her. When the doctor showed me the photos I said where’s the photo of the polyp, and instead he just pointed at what appears to be nothing and said “that’s where it was removed”. Except there’s no sign anything was removed. No more-than-average redness, no blood, no pain. There’s 0 reason to think they removed or found anything which I should be relieved about except they’re potentially committing insurance fraud and double charging me/the insurance on top of that. I timed from when I was just about to go under to when I woke up and it was 20 minutes top, probably 5-15 minutes if you subtract the time it likely took me to wake up.

Cost Breakdown for This Claim Service Code(s) Billed by provider Plan discount Allowed by plan Plan paid What you pay

**Colonoscopy W/lesion Removal 00066, 00067 $1,600.00 $385.68 $1,214.32 $910.74 $303.58

**Colonoscopy And Biopsy 00066, 00067 $1,500.00 $1,201.24 $298.76 $224.07 $74.69

Total $3,100.00 -$1,586.92 $1,513.08 -$1,134.81 $378.27

Service Code(s) Billed by provider Plan discount Allowed by plan Plan paid What you pay

**Anesthesia 00067, 00066 $3,000.00 $2,500.00 $500.00 $375.00 $125.00 Total

What can/should I do about this? I have a post-colonoscopy appointment with him in a few days and I’m not sure I’ll even be able to get in because the front desk will probably bring up the unpaid balance. I’m willing to make monthly payments but I need to get one of the claims removed or the amount owed by me reduced. Further how can I trust any treatments/medication he recommends now if he’s shown such disregard with everything else?

Did I both financially and physically, literally take one up the….?