VHI and the "repeat rule" - what's this?

S

sitstill

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I had a colonoscopy and treatment in May at the Beacon for which I claimed from VHI. Unfortunately, I need to have the treatment done again because it was not entirely successful. When I spoke to a woman from VHI she told me that they will only pay for one colonoscopy every 36 months "unless the procedure is allowable under the repeat rule" and I should check this with the surgeon prior to having the procedure.

Does anyone know what this means or if it sounds like my case will be allowed? I rang the surgeon today but he was not available. Thanks.
 
It's funny if a tiler, a builder or plumber made a bags of something they would have to make good for free of charge. There are different procedure codes for every medical procedure carried out and some carry rules that prevent "repeat business". There are some procedures that are ever so slightly different also and are allowable though.

There are also rules in force where if surgery is carried out on multiple sites (the body that is), some insurers have a sliding scale of cover ranging from 100% to 50%.

Patrick
 
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