Second Necessary Colonoscopy Not Covered
I'm a 69 year old male, still working and under my employer's health insurance (Allied). I had a colonoscopy, as one is supposed to do, and the doctor gave me a 1 day prep, which I followed to the letter. However, during the colonscopy, the Dr. determined that the 1 day prep was insufficient. We scheduled a repeat a month later with a 2 day prep, and it went fine. I then got a bill for about $22K…turns out my insurance didn't cover the second colonoscopy at all. Rationale: you have to wait 5 years before a second colonscopy. Got a letter from the Dr. about how it was medically necessary, appealed the decision and it was turned down for exactly the original reason…too soon. I know both the Dr. and hospital checked insurance before proceeding, so I'm bewildered as to where things screwed up. I'm wondering what recourse I have, short of going legal, going to the media? Has anyone had this situation? It's not like I'm doing colonoscopies recreationally!
submitted by /u/Due-Ingenuity704
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