A Chicago couple is speaking out after receiving unexpected charges following routine preventive colonoscopies, which are supposed to be free under the Affordable Care Act
Chicago couple Chantal Panozzo and Brian Opyd received routine preventive colonoscopies that were free under the Affordable Care Act
Due to a loophole in the law, they were still charged $600 for “surgical trays”
Panozzo contested the charges by filing an appeal and wrote to her elected officials arguing that consumers are being "taken advantage of"
An Illinois couple is speaking out after their service provider charged them $600 each for "surgical trays" following routine preventive colonoscopies. After insurance was applied, each patient received a bill for $250.
Chantal Panozzo, 46, and husband Brian Opyd, 45, both scheduled colonoscopies after reaching the recommended age of 45. The screening, provided by Illinois Gastroenterology Group, would cost $2,034 before any insurance discounts or reductions.
However, under the Affordable Care Act, the pair — who live in Chicago and are covered by Blue Cross and Blue Shield of Illinois — were to receive the service free. Their insurance company would be responsible for paying the remaining costs for their screening.
The Affordable Care Act requires preventive care services like colonoscopies, mammograms, and cervical cancer checks to be fully covered without any cost to patients.
"This was our chance to get our free preventative care," Panozzo told NPR, noting that both of their results came back normal.
However, there is a loophole in the law where healthcare providers can still bill for whatever goods or services they choose to list, as long as they abide by the contracts with insurance for the preventative service.
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So, despite the free screening, the couple later received their respective bills for the visit and were surprised to find that they each had a $600 charge for “surgical supplies.” Their insurer explained that the codes were for “surgical trays.” The couple eventually appealed and were not required to pay.
"The insurance company is supposed to pay the full claim, but there is no requirement on the provider to code the claim correctly," Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, told NPR.
GI Alliance, the national group that manages the Illinois Gastroenterology Group, has not yet responded to PEOPLE’s request for comment.
In addition to contesting the charges by filing an appeal with her insurer, Panozzo filed a complaint to the Illinois Department of Insurance. She also wrote to her elected officials arguing that consumers are being "taken advantage of" and "ripped off."
She was relieved when the insurance later approved the appeal and neither she nor her husband were required to pay the charges.
But Panozzo said she still felt defeated and exhausted following the entire ordeal. She admitted that she has little trust in the American health care system, even having lived abroad for nearly 10 years.
"I could function in a health care system in German better than I could here in English," she said.
The American Cancer Society recommends that adults 45 and up get regular colon cancer screenings. They also urge people with symptoms of colon cancer — such as a change in bowel movements, including increased diarrhea, rectal bleeding, dark stools, and unexpected weight loss — to get checked out by a doctor.
Earlier, and more frequent screenings are also recommended if someone has an inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), or a personal or family history of colorectal cancer or colorectal polyps, among other pre-existing conditions.
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Read the original article on People.