The Patient Protection and Affordable Care Act provides colonoscopy procedures free of deductible and copayments costs, but insurers have been fighting the interpretation of the rule in various ways, according to a Medpage Today report.
Earlier this year the Obama administration cracked down on insurers trying to force patients to pay if a polyp is found and removed. However, some insurers are now requiring patients to pay for any follow-up colonoscopies by considering them diagnostic.
Requiring a cost share goes against the law's intention, and Robert Smith, PhD, of the American Cancer Society, says the intent of the law has gotten lost in translation.
Practices can get caught in the gray area as to whom is responsible for the colonoscopy caught. Also, the CPT modifier 33, which indicates the cost share should be waived, cannot yet be processed by insurers despite being added at the beginning of 2012.
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Earlier this year the Obama administration cracked down on insurers trying to force patients to pay if a polyp is found and removed. However, some insurers are now requiring patients to pay for any follow-up colonoscopies by considering them diagnostic.
Requiring a cost share goes against the law's intention, and Robert Smith, PhD, of the American Cancer Society, says the intent of the law has gotten lost in translation.
Practices can get caught in the gray area as to whom is responsible for the colonoscopy caught. Also, the CPT modifier 33, which indicates the cost share should be waived, cannot yet be processed by insurers despite being added at the beginning of 2012.
More Articles on Gastroenterology:
Cantel Medical Purchases Colonoscopy Flushing Device Company
72% of Adults Have Not Sought Physician Help for GI Pain
Physicians Endoscopy Receives Cost Management Performance Award