Bill Dunphy is upset. He said that his insurance company told him his colonoscopy would be 100% covered. He had the procedure done.
He became very angry when he received an $1100 bill. He claims he was misled. I think he may be a few fries short of a Happy Meal, and he's having the wrong end tested. You see, the $1100 bill is for removing polyps they found in the course of the colonoscopy. Dunphy says it's bait and switch. I don't think so. In the first place, he probably signed a release that gave them permission to remove any polyps they found. In the second place, according to his theory, if I went for a mammogram that my insurance covers 100%, and they found a tumor, I could say, "I shouldn't have to pay to have that tumor removed or for radiation or chemotherapy or anything else related to that tumor, because my mammogram is covered. You're pulling the old bait and switch on me."
There is another alternative. They could have just left the polyps in there since the colonoscopy was free and then asked him, "Oh -- did you want us to take those out?"
"'Free' colonoscopy isn't always." The Dallas Morning News; December 29, 2011; p. 4A.
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I think the doctor should explain that the insurance will cover your procedure but not anything beyond that. I can see where one might think that if they say insurance pays some people wouldn't understand if they don't tell them that it might not cover for everything.
Doesn't that fall under patient responsibility? There are hundreds of different policies out there, and the doctor may or may not know what your particular insurance covers and what it doesn't. And what you were covered for last year may have changed this year. Last year, mine covered some things that it doesn't cover this year. It's my responsibility to know what those things are before I have a non-emergency procedure done.
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