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Beginning on January 1, 2015, Independence small
group and individual commercial members will be able to
utilize the new Preventive Plus benefit for colon cancer
preventive screening colonoscopies.
When performed at a freestanding ambulatory surgery
center (Freestanding ASC), the Preventive Plus benefit
fully covers a colon cancer preventive screening
colonoscopy with no member cost-sharing ($0 costsharing;
i.e., no copayment, deductible, or coinsurance).
When the services are performed at a hospital outpatient
facility or hospital-based ASC, the member will incur
cost-sharing of up to $750.
Checking patient eligibility
To verify if a patient has the Preventive Plus benefit,
use the Eligibility and Benefits Inquiry transaction on the
NaviNet® web portal.
Referring patients
Use the Find a
Doctor tool at to locate
Freestanding ASCs and associated gastroenterologists
and colon and rectal surgeons with a Preventive
Plus indicator. The service must be performed at a
Freestanding ASC for members to take advantage of
the $0 cost-sharing.
In early 2015, updates will be made to the Referrals
transaction to assist physicians when referring patients
for colon cancer preventive screening colonoscopies.
Additional information about these enhancements will
be communicated in future editions of Partners in
Health UpdateSM.
Questions
If you have questions regarding the Preventive Plus
benefit, you may call 1-800-ASK-BLUE or contact your
Network Coordinator.
NaviNet® is a registered trademark of
NaviNet, Inc., an independent company.
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