Endoscopy is a procedure that allows a doctor to view the inside of your body.
It is a day procedure, where you will be admitted and discharged on the same day. Sedation will be given to you with your consent prior to the procedure to ensure your comfort during the procedure.
There are many forms of endoscopy which include gastroscopy, enteroscopy, endoscopic ultrasound (EUS), endoscopic retrograde cholangiopancreatography (ERCP), colonoscopy, and sigmoidoscopy.
How much it cost for Endoscopy
Different forms of endoscopy cost differently and it can vary. Gastrointestinal endoscopies are among the most common procedures seen in IP claims.
I've found this bill amount description for "Intestine/Stomach, Upper Gl endoscopy with / without biopsy
TOSP Code: SF701I/ TOSP Table: 1B". Refer to link by MOH here
Below is the cost for private hospitals.
Compare it with the next table for cost for government hospitals without subsidy.
You'd realise that Day Surgery could half the price vs private hospital!
This bill difference may be seen for all endoscopy procedures.
If you are on a integrated shield plan (IP) 95% rider, do consider the potential cost difference.
All insurers will allow claims for diagnostic endoscopy
The Life Insurance Association, LIA, clarified that Diagnostic endoscopy is a common procedure that allows doctors to look inside a patient's body and detect diseases, which are medically necessary.
Insurers will NO longer be disallowing claims for diagnostic endoscopy, when it is medically necessary.
And regardless of the outcome of the procedure.
After all, endoscopy diagnosis is a reliable way of detecting some of the more common cancers in Singapore.
However, other standalone diagnostics (e.g. x-rays and MRIs) that are not associated with inpatient treatment or hospitalisation continues to be excluded from the policy.
Table of surgical procedures for which medishield life can be claimable, refer to this link.
AVIVA's now also allows claims for endoscopy
According to the Straits Times news article, Aviva previously took "a stricter stance in claims assessment towards a small number of claims for standalone endoscopies that were NOT associated with in-patient treatment or hospitalisation".
This was a stance made from March2020 and created some controversy.
However, AVIVA has since reversed the stance already and will approve claims for endoscopies because they are day surgical operations, even if they do not lead to in-patient treatment or hospitalisation.
More tips for AVIVA myshield policy holders
If you are insured under AVIVA Myshield, do note the following method of making an appointment to have pre-authorization of claims:
• Online or Call 1800 8800 880
Claims process can be done via Aviva ClaimConnect portal or by downloading their app.
Summary
Almost all insurers now work with a “panel of doctors” method. This includes AVIVA Myshield.
There may be limitations to the bill claim if it is outside of the insurer's panel.
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