nope josh, they are covered... even though the docs do not state as much... tex should back me up here
Outpatient Testing BEFORE deductible?
- Thread starter joshril
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nope josh, they are covered... even though the docs do not state as much... tex should back me up here
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- #12
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I bet the agent didn't mention the limit...
We're all on the same page that there's nothing out there that will pay if the doctor refers them to an outpatient testing facility for test though?
It looks to me like all these plans stipulate that the testing has to be done the same day in the doc's office...
We're all on the same page that there's nothing out there that will pay if the doctor refers them to an outpatient testing facility for test though?
It looks to me like all these plans stipulate that the testing has to be done the same day in the doc's office...
this question is why i try and work with both aetna and unicare because more times than not there is a high probibilty that the lab charges will be covered and clients hate unexpected bills... even if i beat them in the head with the bennys before we do the app... just have a chance of less complaining
the uniucare chick told me labs that were referred out were co pay only... however, i dont trust that yet... until i have it happen i am keeping my big fat trap shut to clients on that
also, cigna is here now with the exact same mgmt team as aetna had b4 so i will wait and see how they handle the claim... right now they still seem to have a problem figuring out their butt from a hole in the ground
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- #15
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Are you serious? Covered with a copay? Is this benefit in the policy or is this a hit-and-miss thing with Aetna?
I'm trying to find a specimen Aetna contract...
who knows hit an miss... or all the time... aetna just figured out their butt is diffeent from a hole in the ground...
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- #17
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This is interesting... I wonder if this is because of the way these things were billed by the doc? Specimen says Diagnostic test and X-ray that the deductible applies, but check this out:
Routine Cancer Screenings (Including, as outlined in Schedule of Charges, mammography, colorectal screenings and prostate specific antigen tests) 100% - Deductible waived...
I assume colorectal screenings would include a colonoscopy, but this is fairly ambiguous wording...
Routine Cancer Screenings (Including, as outlined in Schedule of Charges, mammography, colorectal screenings and prostate specific antigen tests) 100% - Deductible waived...
I assume colorectal screenings would include a colonoscopy, but this is fairly ambiguous wording...
yep... i can only go off of experience and aetna has always paid lab and xray with copay when done there or billed there... i had about 200 clients on ther at one point and no one EVER calle dto bitch me out about what i told them
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- #19
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Thanks for the feedback Peeler!
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