where can I get a free mamography screening in Suffolk?

[Mike_Newman]

Originally Posted by twingles

Yes and either way the place shoukd be aware of that issue. Where I go they schedule next years at the time of this years service and make sure it is at least a year and day later.

I hope the OP follows up. I'm certain if she investigates this tomorrow, she will learn she has a refund coming...

[trusso11783]

Yep. Obama decided that you and all women don't need mamograms every year so it isn't covered annually because it is a waste of money.

[Mike_Newman]

Originally Posted by trusso11783

Yep. Obama decided that you and all women don't need mamograms every year so it isn't covered annually because it is a waste of money.

Not sure what you're referring to, but the key here is age. Over age 40, preventive mammograms are covered "every one to two years".

Insurance companies would much rather pay for the test than they would the ensuing treatment of a later stage discovery.

[lubby]

Originally Posted by Mike_Newman

Not sure what you're referring to, but the key here is age. Over age 40, preventive mammograms are covered "every one to two years".

Insurance companies would much rather pay for the test than they would the ensuing treatment of a later stage discovery.

You are right they did code this as diagnostic. It should be preventative. This is last years claim. Can I still dispute it with Good Sam even though I am paying the bill? I will call Empire tomorrow I never realized there was a difference. Thank you so much for your help. You really helped me to better understand my claim. Do you work for an insurance co . I just told my husband your advice and he agreed I should look into this further.

[Mike_Newman]

Originally Posted by lubby

You are right they did code this as diagnostic. It should be preventative. This is last years claim. Can I still dispute it with Good Sam even though I am paying the bill? I will call Empire tomorrow I never realized there was a difference. Thank you so much for your help. You really helped me to better understand my claim. Do you work for an insurance co . I just told my husband your advice and he agreed I should look into this further.

I had a similar situation with Empire, you should be fine. They refunded a $300 deductible that they took from me in error (and denied two appeals)..The proof that I needed to overturn it didn't come out until 3 years later...they refunded my money then. You should be OK.

What you need to do is call Good Sam and explain to them that this is your annual screening and should have been coded as preventive. I assume you were paying them, so they should re-submit the claim correctly, and then refund your deductible as soon as they get an EOB from Empire. They should know right away that they're wrong...if it were me, I'd ask that they cease to expect any more installments, and refund what's been paid so far. The law here is cut and dried. Empire should be in your corner with this as well. As long as there wasn't some underlying reason where a doctor found something and suggested this test...that would make it diagnostic, and thus, coded correctly. From what you said, it was just an annual screening. If that's the case, then everything stated here applies to you.

I would also take Twingles' advice from earlier and be sure that your next mammo is scheduled more than 365 days after your last.

Glad I could help.

[lubby]

Ok so I called Empire today and they explained the claim to me. It was billed this way because when they took the initial mammogram they said they found something and I had to go back for a sonogram. I do owe this money. I was told when I go back again to tell them this is for my routine annual mammogram. They should bill it correctly providing they did not find anything and Empire said I will not have to pay.

[Mike_Newman]

Originally Posted by lubby

Ok so I called Empire today and they explained the claim to me. It was billed this way because when they took the initial mammogram they said they found something and I had to go back for a sonogram. I do owe this money. I was told when I go back again to tell them this is for my routine annual mammogram. They should bill it correctly providing they did not find anything and Empire said I will not have to pay.

I sent you a DM.