My Story: Trying to Get a Virtual Colonoscopy

Dear Bonnie,

 

I am writing in the hope that my experience might help your other clients. Based on the research you presented about colonography, I decided that my first colon cancer screening would be a virtual colonoscopy instead of traditional, invasive colonoscopy. You are often ahead of your time, and I believe this is one of those cases. Over the course of several weeks this summer, I spent the equivalent of two or three days on the phone trying to find someone who would do a CT scan of the colon. I learned some things that might shorten this search for your other clients.

 

Tip Number One. Unbelievably, most medical offices and hospital personnel I spoke with did not know the terms colonography or virtual colonoscopy. Everyone understood CT scan of the colon. Save yourself some trouble and just inquire about CT scan. [I spoke with two doctors who of course knew all the terms; the people not in the know were the people answering phones.]

 

Tip Number Two. Don’t waste time calling gastroenterologist offices. You might want a gastro specialist if the test comes back positive. But you don’t need one to order the test. All the gastro offices I talked with said they don’t recommend CT scans as a screening tool. The only time they want a CT scan of the colon is to follow up traditional colonoscopy. This seems backward to me, but that’s what a number of them told me.

 

Tip Number Three. Find a facility that performs and reads the CT scan; get the radiology fax number for the order and scheduling phone number. Then ask your primary care doctor to fax in the order for the test for you. Then you call the facility to schedule.

 

Tip Number Four. When calling facilities, ask for the GI Lab. I don’t know if that’s part of Radiology or what, but every hospital I called sent me to their GI Lab. I had been told by a number of gastro offices that if a CT scan of the colon is needed, they send all those patients to Northwestern Memorial Hospital in downtown Chicago. For convenience, I really wanted to find a Lake County hospital, but I couldn’t. My second-to-last call (before resigning myself to going into the city) was to Northwest Community Hospital in Arlington Heights. It’s not Lake County, but at least it’s familiar territory and an easy drive. They did my CT scan two weeks ago. They were wonderfully helpful and knowledgeable from my first phone call to them to the procedure itself.

 

Tip Number Five. Paying for the test might be tricky depending on your hospital’s and your insurance company’s policies. I recommend calling your insurance company at least twice and asking different representatives if you’re covered. I was first told insurance covered colon cancer screenings 100 percent. Then I was told they cover diagnostic tests 100 percent, but for just a routine CT screening, I’d have a $100 copay. Another wrinkle was the hospital’s policy. If I had gone in for traditional colonoscopy, Northwest Community Hospital would have billed insurance directly. Since my colonoscopy was virtual, I would have to self-pay $867. Upon registration, I found because they list self-pays as uninsured, my cost would be $442.17. So that is what I will submit to my insurance company. It remains to be seen how much they’ll cover. I hope I will have no more than the $100 copay. The hospital gave me the procedure code so that I could call the radiologist company that would bill separately for reading the CT scan. Again, it took several phone calls and being told the virtual colonoscopy code wasn’t even in their system before I reached someone who said their charge would be about $335, exact amount depending on I’m not sure what, and they would bill my insurance directly. My insurance company would not commit on the second charge, because their coverage of the reading would depend on if the individual radiologist doing the reading was in-network. So I guess I’ll just have to wait to find out how much that might cost me.

 

A general summary of my experience is that most involved parties do not really know how to handle virtual colonoscopy. They must not have had to deal with it much. Great news though: The two doctors I spoke with in my primary care practice were fairly enthusiastic about my request for this less invasive screening, and they both seemed familiar with positive research about colonography’s effectiveness. There is hope!

Sincerely,

Jane