Couple Charged Hundreds in Extra Fees for Routine Preventive Colonoscopy 

By Consumers for Quality Care, on February 14, 2024

An Illinois couple was charged hundreds of dollars for a routine preventive care colonoscopy that they believed would be covered by their insurance, according to KFF Health News.  

Chantal Panozzo, 46, and Brian Opyd, 45, followed the medical recommendation to receive colonoscopies. As small business owners, they purchased their health insurance through the Affordable Care Act (ACA) marketplace. The law provides for free preventive services, which the couple was excited to use. 

The results came back as normal, but they were each hit with unexpected, unexplained $600 charges. Panozzo and her husband later learned that the charges were for “surgical supplies,” specifically, “surgical trays.”  

The Affordable Care Act (ACA) mandates that preventive health care be free of charge to consumers. However, providers can charge for additional goods or services administered to preventive procedures, leading to unexpectedly large bills. Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University, called attention to this flaw, stating, “The insurance company is supposed to pay the full claim, but there is no requirement on the provider to code the claim correctly.”  

Panozzo filed a complaint with the Illinois Department of Insurance and wrote letters to her elected officials, bringing her experience to their attention. Eventually, their insurer approved both appeals, releasing the couple from any obligation to pay the charges. But now, at the end of this ordeal, Panozzo says she no longer trusts that the American health care system works to put patients first.  

CQC applauds Chantal and Brian for sharing their story and for their willingness to challenge these absurd charges. Consumers must be made aware that preventive procedures, such as colonoscopy screenings, are covered under the ACA. CQC urges lawmakers and regulators to hold doctors and hospitals accountable for wrongfully charging consumers for this care.