[ksilty]

Originally Posted by spacenurse

How about doctors and nurses persuading people to be screened?

I know when I changed insurance companies I suddenly needed tests I didn't need before.
Maybe it would be good for them to say, "With your family history I think you should have a yearly mammogram. Your insurance will only pay every other year but I want you to have one."

A friend paid only $80.00 for her mammogram.

Many insurance companies will waive the every-two -year rule if you have a first-degree family history. Insurance companies are spending large amounts of money trying to get members and providers on board with preventive medicine and health screenings. Most provide their providers with Standards of Care when signing a contract. Getting these docs to order standards of care is bad enough, but getting most patients to comply is an even greater challenge. I like the ADA commercial that tells us,"Diabetes won't kill you, failing to control your Diabetes will". If I can get my patients to get an A1c every 3 months, I feel like I have achieved a major victory......

[pickledpepperRN]

My friend was denied payment for a mammogram because she was under 50. Her mother and aunt had died from breast cancer and her sister a surviver. She paid for hers. Her insurance did pay for the needle biopsy, surgery, and continuing treatment.

She is going through the process of arbitration for them to reimburse her for the "unecessary" procedure her doctor recommended.

She is a fine nurse and kind person. I am very glad her doctor told her it was called for. Her prognosis is excellent.

[azhiker96]

I hope your friend is able to get reimbursed for the mammogram. A little extra $ for the trouble would be nice too.

My wife has had mammograms approved and paid by insurance even though she was under 50 at the time. It may vary with the insurance company and maybe even within the insurance company.

On another blog, I posted a poor experience I had trying to get BCBS to pay for an operation. Another poster, who I know and respect, had nothing but praise for BCBS for the way they helped her thru detection and treatment of breast ca.

I wish there were reputable statistics we could reference rather than anecdotes. Evidence based practice is the best way to go, imo.