Understanding the Difference – Screening verses Diagnostic Mammograms
Today many of us are enrolled in high deductible insurance plans. To better assist you with understanding how your insurance impacts exams and services at Windsong, please keep in mind the following factors which directly influence your healthcare costs. Please note that if you are underinsured or uninsured, the Cancer Services Program in your County may be able to assist you. SCREENING MAMMOGRAM (Routine, Preventive Service, Yearly) – Performed on patients who have not had any concerns. Two standard views of each breast are taken to detect unsuspected breast cancer in asymptomatic women 40 years of age or older. This may become a diagnostic exam, if a concern is noted. DIAGNOSTIC MAMMOGRAM (Non-Routine) – Performed on patients who have any exam that is not normal. This can include imaging findings of concern, such as a lump or pain, or other signs and/or symptoms of breast disease, or prior imaging findings that required specific follow-up. Please note that this exam may be subject to a high deductible, co-pay or co-insurance dependent upon you insurance. Based upon the radiologist’s recommendation, your next exam may also be a diagnostic exam. Patients out of pocket cost of healthcare services are based on their insurance policy and may include the following: Deductible – What you must pay for medical expenses before your health plan begins to pay. Copay – A predetermined amount you must pay for certain services. Preventive services – Those services such as mammogram screening that may be covered in full by certain health insurance plans. Please review your “Explanation of Benefits” (EOB) to better understand what medical treatment or services you received, the amount to be billed, payments made, and what amount – if any – you are responsible for. Questions related to billing? Please call (716) 631-2592
