All posts by Dr. Gentry

Will Insurance Cover My Colonoscopy?

The Affordable Care Act requires recommended preventative services, such as colonoscopies, be covered at no cost to the patient. However, strict guidelines are used by insurance companies to determine whether a colonoscopy is categorized as preventative or diagnostic, which can impact your potential out of pocket cost.

Before your colonoscopy we want to help you plan for the potential costs. Much of this starts with understanding the reason for your colonoscopy. Is it preventive, such as a routine colonoscopy, or it diagnostic for evaluation reasons or treat existing condition?

Is My Colonoscopy Preventative or Diagnostic: What You Need to Know

Preventative Colonoscopy Screening: Patient is asymptomatic (no present gastrointestinal ssymptoms), is age 50 or older, and has no personal history of gastrointestinal disease, colon polyps and/or cancer. A colonoscopy has not been performed within the past ten years. This is usually a routine screening colonoscopy and covered by most insurance plans

Surveillance / High-Risk Colonoscopy: Patient is asymptomatic (no present gastrointestinal symptoms) but has a personal history of gastrointestinal disease (such as diverticulitis, Crohn’s disease or ulcerative colitis), colon polyps and/or cancer. Shorter intervals between colonoscopies are recommended for these patients (usually every 2-5 years). Some insurance carriers consider surveillance / high-risk colonoscopies to be preventative, while others consider them to be diagnostic. This is an important note and something to ask your insurance provider.

Diagnostic / Therapeutic Colonoscopy: A colonoscopy is performed to evaluate or treat gastrointestinal symptoms, colon polyps or gastrointestinal disease.

Before your procedure you should know your colonoscopy category. You should obtain the pre-procedure diagnosis code (meaning the reason for the procedure) from the scheduler or medical assistant. With this information you can contact your insurance carrier to determine:

Is a colonoscopy procedure with this diagnosis (provided by scheduler or medical assistant) covered under my policy?

If so, will the diagnosis be processed as preventative or diagnostic? If my procedure will be diagnostic, will the allowable amount be allocated to my deductible? Once the deductible is met, will any additional amounts be allocated to coinsurance? Please note: If your procedure will be performed at one of our endoscopy center locations be sure to tell your insurance carrier that the procedure will NOT be performed in an outpatient setting.

If the procedure will be considered as diagnostic and the allowable amount will be allocated to your deductible, please contact the CRS Business Office at (804) 249-2465 for an estimate of what you can expect to pay.

The physicians at CRS cannot change the primary diagnosis for the sole purpose of coverage determination. The diagnosis must be an accurate reflection of your medical history and the information you provide during our pre-procedure assessment. This is a regulatory requirement imposed by both government agencies and insurance companies with whom we are under contract.

Get in touch to ask a question or click here to schedule your colonoscopy in any of our 3 Richmond area locations.

American Cancer Society Updates Colorectal Screening Guidelines

colonoscopy richmond vaThe American Cancer Society recently announced new colorectal cancer screening guidelines.

One of the most notable change is lowering the age most people should  begin screenings to 45 and even earlier for those with an above average or high risk of developing colon cancer.

Click the link to read the full list of colon cancer screening guidelines.

If it is time to schedule your first colonoscopy, or a follow up get in touch to schedule your appointment online with the providers at Colon & Rectal specialists.

Honduran Pride

Day 4

Today was a long bus ride to La Cucilla Concepcion. A day where the travel, the work, and the exhaustion catch up to you. After a 1 1/2 drive through the mountains , we arrived surprised to find out that the 85 families we were supposed to see had grown to 135! All hands on deck!

I observed our team really come together as we plowed through the scores of families. We saw over 320 patients, dewormed 185 kids and extracted 87 teeth! Well done by everyone!

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Sadness in Honduras

Honduras Day #3

Unfortuntely, there are days when sadness has to boundary or limits of latitudes.

Today we were in clinic and I looked across the school room converted into a Medical Clinic and noticed an elderly woman being helped and supported by another man. She was hunched over and seemed to be unstable. We quickly made room for her at our station.

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Honduras Day 1

Today we travelled about 1 1/2 hours to the town of Santa Barbara to a nice size village that had electricity and some running water. Interestingly, there were many children within the village  with very great oral care and teeth. The parents not so much. The reason this is important is that FOB (as well as other outreach organizations) have been educating the village about the importance of brushing in the last several years! It seems to have taken hold in the parents. Our dentist Dr. Claire Kaugers extracted 23 teeth in her clinic today. Mostly adults. I had a poor little fella, Roger, who was 5 that had pain and drooling so bad because of the need to pull rotten teeth that he needed referral to her. Unfortunately, we had already closed dental and he could not get those teeth pulled. So, we do struggle to get it all done.

Nonetheless, I was blessed to have Andrea, a fantastic 23 year old Honduran who is studying International business, translate for me. We individually examined 39 patients. (See photos)

My favorite group was a woman and her 3 daughters. Ages 17, 13, and 12. They were so beautiful and were in great health. Once I finished with the girls, I asked mom how she was. At that exact time my daughter Sarah Kate who had been in the vitamin and deworming station walks up. So the mother then says, “She had been having headaches,” Looking at her and her 3 daughters and me looking to my right at mine made me realize the common bond we shared as parents. Two different cultures, two different socioeconomic situations, and languages… But one common bond: the love for your children. I smiled at mom and relayed to her that, “this is my daughter ( and with a smile pointing to our girls collectively)  and I have headaches too!”

Our group of 16 made it back safely after seeing 213 patients and rested for the afternoon. Dinner was talapia from the local farms and Virginia the cook made her flam dessert. The power then went out, as it does from time to time, which is why this blog is a little delayed. We played cards by candlelight ( a game called Rat-atat- Cat) and then hit the hay.

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