Hi, I just had my first mammogram at Stamford hospital. The technician stated that I had dense breast tissue and therefore required an additional ultrasound. Low and behold of course now have a $500 bill for this additional testing even though an annual mammogram is supposed to be fully covered under preventative care. Hospital refusing to change billing code. It seems to me an easy way for the hospital to simply make a classification for a patient that would lead to more profitable procedures being performed. Anyone encounter something similar and we’re able to get the claim resolved?

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WhiskyBowTies t1_is1nr66 wrote on October 12, 2022 at 5:29 PM

Stamford Hospital is notorious for sending bills to patients before sending them to the insurance company. The best I can say is to get the insurance company on the line.

Source: family member has chronic medical issue and is cared for at Stamford Hospital.

Trigirl153 OP t1_is1rnh1 wrote on October 12, 2022 at 5:54 PM

Yeah I’m very been on the phone with my OB, insurance company and the hospital. My Dr is trying to change the order coding but is getting pushback from the hospital. The hospital is stating it’s a separate test and the insurance company is saying they have to go by the codes on the bill. Found this today: https://www.cga.ct.gov/2022/fc/pdf/2022SB-00358-R000356-FC.pdf So essentially CT recognized this shady shit and enacted a bill to cover additional testing.

TeachingDazzling6043 t1_is3rmhq wrote on October 13, 2022 at 2:08 AM

Keep bugging your ob office about it. They care about patient satisfaction and will usually help to resolve things like this. See if you can speak to a practice manager or even a nurse about it. I don’t think your insurance can do anything since it’s coded this way.

Lavenderfieldsforeve t1_is1jdse wrote on October 12, 2022 at 5:00 PM

Sorry to hear this - did you have it done at Tully Health Center? I once went to the Emergency part of Tully and received a HUGE bill for it.

Trigirl153 OP t1_is1ko0e wrote on October 12, 2022 at 5:09 PM

Yes, the mammogram/radiology is part of that building. Just seems like shady business practices to me. Like how insurance companies used to deny people medical coverage because they have “pre-existing” condition.

[deleted] t1_is1ruuz wrote on October 12, 2022 at 5:55 PM

Get on the phone with insurance. Not uncommon for hospitals to stop acting as shitty once your insurance is directly involved. Best of luck!

unCloakOuRhero t1_is2xg8t wrote on October 12, 2022 at 10:26 PM

I can't answer your question, but I thought to recommend Rye Radiology in the future. I, too, have dense breast tissue and have been going there for a few decades. I've never been billed extra. So, not sure if the issue is insurance-specific for you, but next year I'd give Rye Radiology a call and talk to them about it.

PikaChooChee t1_is2rvmd wrote on October 12, 2022 at 9:47 PM

Don’t let this go to collections. Stamford Hospital sent a bill that I thought was covered by insurance to collections. I spent hours and hours getting this removed from my credit.

NoraClavicle t1_is45znt wrote on October 13, 2022 at 4:10 AM

Advanced Radiology on East Main is legit one third the price of any procedures offered at Tully/Stamford Hospital. It was explained to me that hospitals charge a huge premium just because the procedure or imaging is done at the hospital building. I haven’t been overcharged with mammograms at Darien Imaging (also through Stamford Health) but anything expensive like an MRI, I go to Advanced Radiology.