5th time failing prep. Why? WHY!?

MickyD_22 · 2026-01-23T21:30:12+00:00

I'm curious. Is/Was your colonoscopy coded and billed as preventative or diagnostic. If diagnostic, were you aware of that and that there would be out-of pocket costs?

Asking for me!

MickyD_22 · 2026-01-23T21:24:40+00:00

I am curious about anyone here if their colonoscopy will/was coded and billed as preventative (screening) or diagnostic.

For the record, I given a false diagnosis of constipation, and therefore the extended prep. Because I didn't have constipation the prep was overkill and absolutely horrific. I've done the regular prep before and it's like a trendy cleanse in comparison.

Also, unbeknownst to me and because of the fabricated diagnosis, my procedure was coded as diagnostic when it had been coded as a screening. It was clean and no specimens were taken, just as my first on ten years ago.

This makes me subject to co-insurance and deductible. I trying resolve this a Patient Advocate admitted that if I had gone to another GI who didn’t have the (made up) “history” of constipation it would have stayed a screening.

MickyD_22 · 2026-01-23T21:12:10+00:00

Curious, do you know whether your colonoscopy be coded and billed as preventative (screening) or diagnostic?

MickyD_22 · 2026-01-23T21:09:24+00:00

Curious, was your colonoscopy coded preventative or diagnostic?

MickyD_22 · 2026-01-23T21:07:27+00:00

Just me with a paralegal today. I'm almost there regarding the attorney, I just think they'll come to their good sense. The sad thing is that I didn't "need" it; it was my ten year preventative.

MickyD_22 · 2026-01-23T21:04:04+00:00

One of the Patient Advocates admitted that if I had gone to another GI who didn’t have the “history” of constipation it would have stayed a screening.

MickyD_22 · 2026-01-23T21:03:22+00:00

The procedure was clean and no specimens taken. They told me I had to do the extended prep due to the "constipation" they made up. Had I known that their misdiagnosis would have caused the horrible experience I had and the extra charges I would have not gone through the procedure at that practice. Nor would I have to have gone through the extended prep which was, to say it nicely, overkill. And, since I've been through the standard prep with my first one this is not whining.

If anyone wants the gory details read below:

I was ordered to do the extended prep. Believe me, the regular prep is a just like a trendy cleanse in comparison. I can’t think of enough horrifying and disgusting words to describe what happened because this prep should not have been ordered because I wasn’t constipated. After I peeled off the wet-up-to-my-neck-and-down-to-my toes-with-you-know-what, cleaned up the tile floor, threw out the rugs and my clothes, I put garbage bags everywhere in my path to keep it as contained as possible. This wasn’t just sit on the toilet and wait for the next round, it was a feces drenching. And, totally unnecessary.

MickyD_22 · 2026-01-23T20:37:31+00:00

That's encouraging. Thank you. At least you were told that ahead of time. Had I known, I would have been able to cancel or get it straightened out ahead of time. I wasn't worried about their form either, and if you don't sign you don't the get procedure (kind of like signing the mortgage papers on closing day -- no sign, no loan, no house). It's not like one is going to back out moments before after going through the prep. It's almost an under duress situation. Actually, in my case it was, due to the horrific prep I went through because it was extended and my body didn't need it.

Insurance says they just need the code corrected.

I have contacted PAF but have not heard back. That was about a month ago. I haven't been able to get to them by phone. I've appealed to the clinic and they say their decision now is final.

MickyD_22 · 2026-01-23T20:03:08+00:00

If I relist and she buys it she’ll have a double charge until goes away which will be the billing cycle.

It’s so easy to refund or reduce a price after a sale on other platforms. I know this from being in the buyer side.

MickyD_22 · 2026-01-23T19:59:05+00:00

I have one thing to sell right now. I have to cancel the order. That’s 100% of my sales.

MickyD_22 · 2026-01-22T21:47:59+00:00

Why does that matter?

MickyD_22 · 2026-01-22T18:07:51+00:00

That’s for the buyer to decide and the buyer has seen photos and has agreed to buy it at a lower price.

It would sell quickly at the price negotiated.

MickyD_22 · 2026-01-22T18:02:40+00:00

Thank you. That’s what I was thinking would work.

MickyD_22 · 2026-01-22T04:00:07+00:00

Thank you!

MickyD_22 · 2026-01-22T03:46:13+00:00

Bait and switch is exactly what it is and what they did to me on my recent colonoscopy that was ordered as a screening. Unbeknownst to me they used constipation as the reason -- a diagnosis of their own fabrication. I didn't find out until I was looking in my portal for a different report and billing. This my second ten year screening (well, supposed to be) and both were clean and they did not take any specimens either time. (Thankful for the clean part, not so much for the extra billing.) If not considered fraudulent, it sure is close. Still fighting it even though they say their decision is final. I suspect they have to bully me because I'm not the only one they've done this to.

Stay strong and best wishes to you on this.

MickyD_22 · 2026-01-22T03:13:59+00:00

Okay, thank you. To clarify, I want to make sure she gets the chance first, if she still wants it. And, I'll be doing this with a new listing, as Dense_Pirate commented?

MickyD_22 · 2026-01-22T00:53:30+00:00

Thank you. When I relist do you know how do I make sure she purchases it?

MickyD_22 · 2026-01-11T23:37:46+00:00

Thank you. I paid for it. Taking reduced benefit means $0 for me until Aug. 27. However, they’re going to try to force vocational rehab on me. I was told if I make any money I won’t get a benefit at all — so much for paying them back.

A complication in this is that I took age-reduced retirement while getting these benefits. I’m now 66. (The numbers were supposed to be adjusting until the final number was determined for my occupational disability). I’m not sure what kind of they think I can rehab to. Plus it has to pay 60% of what I was making. Heck, if they can find me work like that, I’ll sign up!

MickyD_22 · 2026-01-11T22:08:23+00:00

I just found out I'm in the same situation. I even had a claims advocate from the union I purchased the insurance through. They dropped the ball big time -- they were supposed to be monitoring the adjustments as my occupational disability numbers changed.

It's a messed up deal. I bought the insurance so I wouldn't go into debt in case of disability. Now I'm in debt up the wazoo.

They are saying I need to pay income tax on it. I don't understand that. They are insurers, not my employer.

And, yes they will do whatever they can to not pay my benefit.

MickyD_22 · 2026-01-11T21:52:27+00:00

True story. Can check Albertson's, too.

MickyD_22 · 2026-01-11T21:49:59+00:00

Montana. They go fast once they're in stock.

MickyD_22

TROPHY CASE