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W2R  
#1 Posted : Friday, February 18, 2011 2:18:41 AM(UTC)
W2R

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I have BCBS Standard (self only), and had my first colonoscopy in January. This was at an outpatient endoscopy center.
 
Before they would do the procedure, they warned me that I would have to pay them the entire 2011 $350 deductible up front. I did that, and they agree that I paid that.
 
Now, I am getting billed for the $350 deductible for their anesthetist. This is specifically labeled as a charge for my deductible. When I called the endoscopy center's billing people, they connected me with the endoscopy center which said that there must be another $350 deductible other than the one I paid. They said that BCBS told them I owe another $350 deductible.
 
Is this possible? I called the number on my BCBS Standard member card, and after going through all the voicemail (which took forever) and finally getting to a human being I was put on hold for hours because she couldn't pull the records.
 
What can I do? I tried looking on www.fepblue.com and didn't find anything about two different deductibles.
 
Do I really have to pay over $700 deductible plus various copays for this colonoscopy?
W2R2011-02-18 10:24:59
samac59  
#2 Posted : Friday, February 18, 2011 3:30:35 AM(UTC)
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Check your BCBS brochure.If it was a routine colonoscopy from an in network provider there shouldn't be a deductible. I wouldn't pay anything until you get the explanation of benefits from BCBS.
W2R  
#3 Posted : Saturday, February 19, 2011 12:19:26 PM(UTC)
W2R

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Thanks, samac59.  I appreciate the helpful answer.
Angel1955  
#4 Posted : Saturday, September 24, 2011 7:18:18 AM(UTC)
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Didn't BC pay at least a percentage of the anethisist??  I know they are usually one of those who do their own billing and are not PPO's = I find the BC/BS ifepblue  impossible to log onto - -call another number on the back of your ID card =  I had surgery in one eye - fine - no problems - went back about the other and found out Dr dropped them - - scary   
dianajune  
#5 Posted : Friday, January 13, 2012 10:24:03 PM(UTC)
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W2R wrote:
I have BCBS Standard (self only), and had my first colonoscopy in January. This was at an outpatient endoscopy center.
 
Before they would do the procedure, they warned me that I would have to pay them the entire 2011 $350 deductible up front. I did that, and they agree that I paid that.
 
Now, I am getting billed for the $350 deductible for their anesthetist. This is specifically labeled as a charge for my deductible. When I called the endoscopy center's billing people, they connected me with the endoscopy center which said that there must be another $350 deductible other than the one I paid. They said that BCBS told them I owe another $350 deductible.
 
Is this possible? I called the number on my BCBS Standard member card, and after going through all the voicemail (which took forever) and finally getting to a human being I was put on hold for hours because she couldn't pull the records.
 
What can I do? I tried looking on www.fepblue.com and didn't find anything about two different deductibles.
 
Do I really have to pay over $700 deductible plus various copays for this colonoscopy?

I know your post was written a long time ago, but I've been researching this board to see if any other Federal disabled retirees are having as hard a time as I am with regard to getting adequate health care.  I know I'm not alone.

The costs you mentioned are ridiculous but this doesn't surprise me.  FEHB likes to stick it to us.

I hope you have a better plan this year!
Fed1969  
#6 Posted : Tuesday, January 31, 2012 5:33:04 AM(UTC)
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W2R wrote:
I have BCBS Standard (self only), and had my first colonoscopy in January. This was at an outpatient endoscopy center.
 
Before they would do the procedure, they warned me that I would have to pay them the entire 2011 $350 deductible up front. I did that, and they agree that I paid that.
 
Now, I am getting billed for the $350 deductible for their anesthetist. This is specifically labeled as a charge for my deductible. When I called the endoscopy center's billing people, they connected me with the endoscopy center which said that there must be another $350 deductible other than the one I paid. They said that BCBS told them I owe another $350 deductible.
 
Is this possible? I called the number on my BCBS Standard member card, and after going through all the voicemail (which took forever) and finally getting to a human being I was put on hold for hours because she couldn't pull the records.
 
What can I do? I tried looking on www.fepblue.com and didn't find anything about two different deductibles.
 
Do I really have to pay over $700 deductible plus various copays for this colonoscopy?

I would discuss the issue with BCBS and complain.
GSBS  
#7 Posted : Tuesday, January 31, 2012 5:56:47 AM(UTC)
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In 2011 this procedure along with a routine physical were to be provided at NO charge once a year under BCBS standard plan 104.  I'm thinking this was a non participating provider!
dhacker56  
#8 Posted : Tuesday, January 31, 2012 6:52:23 AM(UTC)
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How old are you?  the routine colonoscopy  benefit is for One every 5 years after the age of 50  I believe.

GSBS  
#9 Posted : Tuesday, January 31, 2012 12:13:36 PM(UTC)
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53, but my sum total of knowledge comes from page 5 of my link, and the Postcard promotion that I brought to my Doctor. Also because my Doctor mentioned it . Of course these other charges for what should have been a free procedure seem about right if the anesthesiologist was not part of the O/P's plan but is associated with the group. It could have been the center was the offender Not only would the Annual Deductible fully apply, but the Doctor or Group is only paid @ 65% of the BCBS usual and customary rate. Any amount over that is also the O/P's responsibility. Why is it we never heard back from W2R on this?
 
Same thing happened to me last year at a Blue Cross network hospital as the ER Doctor had nothing to do with the hospital or insurance. The law has changed since late 2010.   
 
GSBS2012-02-01 18:28:27
Angel1955  
#10 Posted : Wednesday, February 01, 2012 3:14:24 AM(UTC)
Angel1955

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Don't ever go by the he said-she said  - I want everything in black and white - and I register all mail  - I don't have a problem with BC/BS on the phone - and be careful - that happened to me at a major DC hospital - and locally when Dr was billing under two different names - same process, same person - ME - thank heavens I have my on-line bill pay - and took them directly to office manager - it appears the bill goes to their billing office under one name - then it is switched to Florida for follow thru under another U do not send any payments to either of their "services" I mail payment directly to office manager - - - having been in finance for 40 years - I always go by  the black and white in front of me - -it is strange that the anesthesist is charging as much as the surgeon and curious as to why the anesthethist bill is not generated by his office business which a lot are
drlove  
#11 Posted : Wednesday, February 01, 2012 9:38:03 AM(UTC)
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I have BCBS and had a route scope done about two years ago. I only had to pay for Dr's visit..
Angel1955  
#12 Posted : Thursday, April 12, 2012 8:46:16 PM(UTC)
Angel1955

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I can see the first $350.00 paid but the second - wouldn't that come under a different pay schedule since the deductible had been met??   
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