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Colonoscopy Instruction

Screening/ High Risk Colonoscopy Patients For Medicare Beneficiaries

Because Medicare has limitations regarding how often they pay for your screening Colonoscopy, we will routinely be asking you to sign an ABN (Advance Beneficiary Notice) prior to your Colonoscopy being completed. 

The purpose of the ABN is to inform you, the beneficiary, prior to receiving specified items or services; that Medicare may not pay for them. The ABN states that you are responsible for payment, either out-of-pocket or through other insurance, if Medicare does not pay for the procedure. The approximate cost of the Colonoscopy will be listed on the ABN.

Medicare presently pays for the Screening Colonoscopy every 10 years and Screening Colonoscopies for “high risk” patients every 24 months. High risk patients are individuals who have one of more of the following: 

  • A close relative (sibling, parent or child) who has had colorectal cancer of an adenomatous polyp 
  • A family history of familial adenomatous polyposis 
  • A personal history of hereditary nonpolyposis colorectal cancer 
  • A personal history of adenomatous polyps
  •  A personal history of colorectal cancer Inflammatory bowel disease, including Crohn’s Disease, and ulcerative colitis

If you are unsure if you have one of the above listen conditions, please speak with your physician. 

We are required to provide an ABN to allow you to make an informed consumer decision prior to receiving services Medicare may not pay for. If the required amount of time has elapsed since your last Colonoscopy, Medicare benefits should apply.

The fact that Medicare may not pay for your Colonoscopy does not mean you should not have the procedure completed. Your physician has recommended you for a Colonoscopy for a reason. Please discuss your decision with her/him. 

If you have any questions, please feel free to contact our Business Office Monday through Friday 7 a.m. - 4:30 p.m. at 217-532-6111. You may also contact Medicare regarding information on its coverage by calling 1-800-633-4227. 

Please understand that even if this is your first Screening Colonoscopy or you are having the procedure within the recommended time limitations, we are still required to issue an ABN. 

Thank you for choosing Hillsboro Health for your health care needs.

Download a copy of Colonoscopy Instructions

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