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Anesthesiology/anethesia for colonoscopy/ insurance coverage
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Question
In the past, anethesia for my husband's and my colonoscopies have been covered. Suddenly I am told the ins. co. refuses to pay for anethesia because it is not the industry standard of care. My doc said I could pay for an anethesiologist to be put asleep or my gastroenterologist would adminster fentanyl & versed. I chose anethesia for several reasons: 1)In years past, I have been nauesated and dizzy for weeks after minor surgeries from the older drugs as well as fatigued and sleepy, 2) If I am aware of what they are doing to me, I would not ever have the test, 3) if sedation drugs affect heart & BP, then, since I have high BP (well controlled by drugs), shouldn't I be monitored?, 4) I would prefer to have my examining doc paying attention to my exam, not my sedation. 5) the newer drugs have never left me with a hangover and I have been able to resume my daily activities as soon as I arrived home. With these factors in mind, how can an insurance co. deny coverage for an anethesiologist? Any suggestions as to how I can address my inevitable appeal??? Truely, if I'm not "out," there is no way I'd ever have another colonoscopy again!!
Colonoscopies are commonly done with sedation by the gastroenterologist unless there is a medical indication to need an anesthesiaologist (bad heart disease, etc). The GI doc does the procedure while the nurse does the sedation. Versed and Fentanyl should not make you dizzy and is probably what an anesthesiologist would use also. As for how insurance companies can do this, don't get me started (i'm only allowed 65,000 characters). I don't know what to tell you about your appeal. Insurance companies run the business and it is very hard to get them to part with your money!
Ronald Levy, MD
Professor of Anesthesiology
UTMB-Galveston
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Questioner's Rating
| Rating(1-10) | Knowledgeability = 10 | Clarity of Response = 10 | Politeness = 10 |
| Comment | A clear, quick response that gave me a little more info about the meds than I knew before, even though they didn't directly relate to my question. My bottom line is that the insurance companies have all of us -- doctors and patients -- by the short hairs! That doctor at UCLA who has published some studies about sedation not being needed for colonoscopies should be given the cold shoulder by all of his colleagues, both gastroenetrologists and anethesiologists! What he has done is unconscionable to patients who can't tolerate the level of discomfort and pain involved in that procedure. I pay more and get less every year, and the CEO's get another few million dollars more each year in their paycheck. Oh, by the way, I asked an anethesiologist standing next to me in a grocery line this question, and he shook his head and said that he insisted on anethesia for his recent colonoscopy, that he wouldn't have done it without! The true answer is as long as insurance companies have the power, we really don't have medical care directed by our doctors, but by the untrained claims people and doctors who are paid to find reasons to not pay for service. As my husband says, he'd like to take the claims review physician have the letter shoved where the sun doesn't shine -- without sedation! (Guess I shouldn't have gotten started, either). What would they have done if George Bush were president today and had his colonoscopy? My guess is that he'd again have sedation! | ||
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Answers by Expert:
Ronald Levy, M.D.
Expertise
Associate Professor of Anesthesiology, University of Texas Medical Branch at Galveston. I am a board certified anesthesiologist who can answer all questions related to any type of Anesthesia with the exception of Pain Management.
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