Insurance Coverage for Breast Tomosynthesis (3D mammography)
More and more insurance companies are covering Breast Tomosynthesis (3D mammography) which has quickly become the gold standard for diagnostic breast exams. Medicare currently pays for the procedure, as do some commercial insurances.
Unfortunately, at this time there are still some insurance companies unwilling to cover this latest technology and denying the charge as not medically necessary or experimental. So please check with your insurance company regarding coverage for tomosynthesis before scheduling your appointment. If your insurance company denies your claim, the additional charge you may be responsible for 3D (tomosynthesis) is $51.
If your claim is denied, we (ProMedica) will provide you with a copy of an appeal letter to send to your insurance company. Instructions should be included with your explanation of benefits (EOB) on how to appeal a denial.
If you file an appeal with your insurance company, please notify ProMedica Customer Service at 1-844-373-0871 and we will suspend your $51 charge, pending an outcome of the appeal.