Uma Bingham/My Word/The Times-Standard
Article Launched: 04/29/2008 01:27:18 AM PDT
I work at a local non-profit medical clinic as a nurse-practitioner. Most of our clients do not have health insurance, but if they income-qualify we offer them various programs that will enable them to receive their yearly cancer screenings, such as pap smears and mammograms.
One of these programs is called the Cancer Detection Program, funded by the state of California. It pays for screening mammograms and any recommended diagnostic procedures such as breast biopsies.
It is a wonderful program that has saved many women’s lives, I am sure. In fact, I recently referred a woman in her 50s for a routine mammogram through this program, and when it showed some abnormalities, it covered the biopsy which led to a cancer diagnosis. She had a successful lumpectomy and is doing well.
Would she have been able to pay for that initial screening X-ray, or would she have put it off due to financial reasons without the assistance of CDP?
Unfortunately, we have just received a letter from the director of diagnostic imaging at St. Joseph Outpatient Imaging in Eureka informing us they (and Mad River Hospital imaging) “can no longer perform mammograms … for patients that have the Cancer Detection Program.”
The stated reason is that they are not reimbursed for their mammograms because they use digital equipment and CDP does not reimburse for it.
This is not a new development. CDP has never reimbursed for the higher digital fees. Before St. Joe’s took over the Humboldt Radiology Center, we had no trouble referring clients there, even though the equipment was already digital.
I have also spoken with the billing services supervisor for MD Imaging in Redding, where the above-mentioned client had her screening and biopsy, and they stated they simply bill the old analog code for the CDP clients and accept the slightly lower reimbursement.
I do not want to have my clients miss out on essential cancer screening because they cannot afford it or cannot arrange to make the drive to Fortuna, where they still use the non-digital equipment.
I implore the administration of St. Joseph Health System to re-evaluate their priorities and ability to serve the needy in our area.
Uma Bingham is a nurse practitioner at Six Rivers Planned Parenthood. She lives in Eureka.
Category: Pathology News