Upper GI question

[Syrah 0]

Hello all, I am new here!

I am scheduled for an upper GI tomorrow. I have heard that this may not be covered by insurance. Has anyone else experienced this? My banding surgery IS covered by insurance / has been approved. The only thing I have left to do is the upper GI (I did the MMPI already).

It seems odd that the surgery is covered but a diagnostic test being done FOR the surgery is in question. :cry I was told that this surgeon checks everyone for reflux before he'll do the banding.

Thoughts?

Oh, and this looks like a great board. There is a lot of great info here. :biggrin1:

[Alexandra 55]

Hi Syrah!

The reason your upper GI may not be covered by insurance is that it's not a diagnostic test ordered because you have symptoms. Insurance typically only covers things that are medically necessary to diagnose or treat disease; this seems like just a precautionary thing your surgeon does for his own reasons and as such, it may not be covered.

I think it's very unusual for a surgeon to require an upper GI test on all of his patients, including those with no symptoms or history to suggest a problem. If I were more cynical, I'd wonder if he has a part-ownership of the testing facility.

[shutuplena 0]

My surgeon required an upper GI too (endoscopy) along with many other tests as well. It does seem odd that it wouldn't be covered. Is the doctor referring you to a gastro doctor who maybe doesn't participate in your plan? Check with your insurance co and find out what their procedure is. They should cover you.

[soniacan 0]

i think i had to pay almost 200bucks for mine. i was annoyed because I was told I had to go to Rush Hospital to have it done and not at the surgical center. so i make another appointment and go... and then get billed anyway. If theinsurance wasn't going to pay for it I wish it would have all been done at the same time as my pre-op testing. sillyness.