Zurik: With colonoscopies, the worst pain comes with the bill - FOX 8 WVUE New Orleans News, Weather, Sports, Social

Zurik: With colonoscopies, the worst pain comes with the bill

Click to read statements from Tulane Medical Center and Ochsner Health System in response to this story. Fairway Medical Center declined to comment. Click to read statements from Tulane Medical Center and Ochsner Health System in response to this story. Fairway Medical Center declined to comment.
NEW ORLEANS (WVUE) -

If you've ever had a colonoscopy, you probably can relate to Cedric Valeary's story.

"Man, you don't want to drink all that stuff," Valeary tells us. "It is awful."

Now, it's the numerous bills landing in this New Orleans resident's mailbox that leave a bad taste in his mouth.

"It is confusing because, every time I turn around, another one comes," he says of the bills.

As discomfiting as a colonoscopy might be, Valeary says, paying the bills for it are even worse. He had to pay $2,000 out of pocket.

"Definitely, it was a shock to me," he says. "I didn't know until [FOX 8's] story came on, you know, that there are different prices for the same procedure."

Valeary must pay for the procedure, the doctor and the anesthesiologist. His insurance company billed him almost $1,300 for the colonoscopy at Tulane Medical Center, and another $800 to cover the cost of the anesthesiologist.

We showed Valeary our online database, where we found less expensive colonoscopy prices.

"It's upsetting to me," he tells us. "And it was upsetting to me before you started the story. But I didn't know that you could actually have that same procedure for that much less. I don't think that's right.

But it's unclear if Valeary should have paid anything. Per the federal government, a screening colonoscopy must be free for the patient, fully covered by insurance.

A screening is a test provided to a patient in the absence of signs or symptoms. Valeary says he had no signs, no symptoms; his doctor recommended the procedure as a routine screening.

"He scheduled me for a colonoscopy," Valeary recalls. "Well, OK, because I'd never had one. I really just wanted to get one around 50 years old, something like that. And so, I'm 62 - I said, OK, I'm going to get one."

Valeary received clean results. But he could be out $2,000 he should never have paid.

"I don't want to be giving money away just to be giving it away," he says. "You know, I appreciate the colonoscopy, that it came out clean. Yeah, I appreciate that. But if the other side of it's going to make you sick, then what's the point?"

FOX 8 News and our partners at NOLA.com | The Times-Picayune and ClearHealthCosts.com have gathered colonoscopy prices across the New Orleans metro area.

Many FOX 8 viewers have also contributed prices to our database. Some of those prices raise serious questions.

One FOX 8 viewer says he had a routine screening colonoscopy at Fairway Medical Center on the North Shore. His out-of-pocket part of the bill required him to pay $170 for the doctor, $91 for the anesthesiologist and $1,400 for the facility, Fairway Medical.  But when we called Fairway to ask for their "self-pay" or cash price on a colonoscopy, they quoted us $1,172.

A Humana-managed Medicare plan allowed the government to pay $4,100 for this colonoscopy - a high price in our database. The same procedure at Metropolitan Gastroenterology costs $1,500; at NOLA Gastro, $1,200.

Another viewer wrote us, "Medical costs are outrageous," telling us her colonoscopy cost had doubled since her last colonoscopy years ago. She says she pays $700 a month to Blue Cross for insurance, but received five separate bills - all totaled $3,073.

Moreover, her Ochsner bills labeled her colonoscopy an “endoscopy” in the description of service. Three more Ochsner patients submitted colonoscopy bills with the same description. 

Technically, a colonoscopy is a kind of endoscopy, in which doctors examine a person’s digestive tract using a flexible tube. However, there are more than a dozen types and levels of endoscopies; pulmonologists, otorlarygnologists and gastroenterologists all perform them.

"Saying you had an endoscopy is sort of like saying you had surgery," said Dr. Michael Ellis, a professor of otolaryngology and a former president of the Louisiana Medical Society. "If a bill doesn't specify what type of endoscopy you had, there’s no way to know if you were charged for the wrong thing." 

That viewer's colonoscopy is the priciest in our PriceCheck tool. In addition to her $3,073 charge, Blue Cross Blue Shield paid $2,800 - all totaled, nearly $6,000 for one colonoscopy.

"The cost really should not be drastically different," says patients advocate Dave deBronkart of the blog EPatientDave.com. "I know there are some clinics that have luxury waiting rooms, some nice music and so on. But, you know, there is no reason why there should be vast differences. "

Another viewer wrote to us about a routine screening colonoscopy, labeling it a "standard procedure", and called her $1,129 bill "outrageous".

"I'm just ripped off," says Mary Lapara, a North Shore resident.

Lapara knows healthcare well. "I'm a nurse, actually," she tells us.

Lapara shows us her colonoscopy bill; once again, her procedure was labeled an "endoscopy". Her insurance paid $3,900; her out-of-pocket cost was almost $2,100.

"These people certainly do deserve to be paid," she tells us. "But I don't deserve to be gouged. Nobody does."

Lapara says she didn't have time to shop around to see other prices.

"I'd like to know what is the cost of the procedure when I walk in the door," she says. "I know what my insurance says; they'll cover 80 percent. So, 80 percent of what?"

Now she's on a payment plan - her routine procedure will take her two years to pay off.

"I would expect the prices to be pretty fair and equal across the board, and not range by hundreds or thousands of dollars," Lapara tells us. "You expect a few dollars' difference, you know, but not what I have here."

If you're scheduled for a colonoscopy, be sure to ask your doctor whether a screening or a diagnostic procedure is recommended. Again, screening should be free. If there's even a hint of a reason it's not routine - maybe family history, you had a prior colonoscopy diagnosis or you had some other aches - you might be charged for a diagnostic procedure.

--

Remember: we want you to join our investigation. Please contribute your prices, your stories to our database.

We want to see the prices you have to pay on any procedure. 

--            

Copyright 2017 WVUE. All rights reserved.

Powered by Frankly