So, I got a creepy box in the mail I hadn't ordered from a company called "Exact Sciences" and it has "Exempt Human Specimen" written on the side. Creepy. Google tells me:
- This is a cologuard kit
- Users have posted about having been harassed by this company about completing the test
- Posts about high false positive rates exist
- Posts exist of users getting a positive result, scheduling a followup colonoscopy, and insurance then declining to cover it because it is now "diagnostic". Posts also exist reporting that this is no longer true in some states or possibly anywhere due to an A.C.A provision.
My "scam detector" alarm is starting to go off. Maybe this is legit, maybe not, but how did they get my name and number? I want to know who gave them my personal information without permission. So I called them and was told that this is a prescription test kit that had been ordered by CareFirst (my insurance company). So now it seems that a doctor I've never met or been examined by wrote a prescription I didn't request. This is starting to sound like medical fraud and/or malpractice. They told me the name of the physician that wrote the prescription but refused to give me his license #. They also declined to give me a pharmacy license #, which I would think they'd require if they're going to be filling prescriptions. I called CareFirst. They admit they requested the kit but the representative did not think it required a prescription. They say they sent me an "opt-out" letter in the mail. Maybe that makes this whole thing barely legal.
Recap:
- Insurance company sends "opt-out" letter (or so they claim) and receives no response.
- CareFirst (according to Exact Sciences) has Dr Raphael O******e create a prescription, which he does without ever meeting or examining me.
- CareFirst sends the prescription to be filled by a non-pharmacy and gives them my personal information without my consent.
- Both companies refuse to provide me with a copy of the prescription.
So, does this sound like fraud or a HIPAA violation to anyone? Or do I just make peace with my Insurance company giving out my info to whomever wants to send me medical waste via UPS?
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