Insurance reimbursement for risk-reducing mastectomy and oophorectomy in women with BRCA1 or BRCA2 mutations Journal Article
| Authors: | Kauff, N. D.; Scheuer, L.; Robson, M. E.; Glogowski, E.; Kelly, B.; Barakat, R.; Heerdt, A.; Borgen, P. I.; Davis, J. G.; Offit, K. |
| Article Title: | Insurance reimbursement for risk-reducing mastectomy and oophorectomy in women with BRCA1 or BRCA2 mutations |
| Abstract: | Purpose: Risk-reducing surgery is an important option for women with BRCA1 and BRCA2 mutations. There are reports in the literature that insurance reimbursement for these procedures varies greatly. Because health insurance coverage significantly affects medical decision-making, current information regarding reimbursement practices of third-party payers is needed. Methods: Retrospective study of hospital billing records of 38 women with documented BRCA1 or BRCA2 mutations who underwent either a risk-reducing mastectomy or a risk-reducing oophorectomy between March 1, 1997, and July 30, 2000. Results: Complete billing and reimbursement information was available for 35 women undergoing a total of 39 risk-reducing surgeries. A total of 38 of 39 (97%) risk-reducing surgeries were covered in full, less applicable coinsurance and deductibles. The rate of insurance reimbursement did not vary with type of insurance, personal history of cancer, or type of procedure. Conclusion: Insurance carriers reimbursed the vast majority of BRCA mutation carriers undergoing risk-reducing surgery. |
| Keywords: | adult; clinical article; middle aged; retrospective studies; gene mutation; mutation; anamnesis; cancer risk; medical decision making; ovarian neoplasms; genetic predisposition to disease; cancer prevention; ovary cancer; breast cancer; mastectomy; ovariectomy; risk factors; breast neoplasms; brca1 protein; brca2 protein; heterozygote; retrospective study; information processing; health insurance; reimbursement; genes, brca1; population risk; data analysis; insurance; medical literature; medical documentation; new york; decision making; brca1; brca2; genetic counseling; risk management; insurance, health, reimbursement; prophylactic surgery; information; insurance coverage; managed care programs; hospital billing; humans; human; female; article; hospital records |
| Journal Title: | Genetics in Medicine |
| Volume: | 3 |
| Issue: | 6 |
| ISSN: | 1098-3600 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2001-11-01 |
| Start Page: | 422 |
| End Page: | 425 |
| Language: | English |
| PUBMED: | 11715007 |
| PROVIDER: | scopus |
| DOI: | 10.1097/00125817-200111000-00008 |
| DOI/URL: | |
| Notes: | Export Date: 21 May 2015 -- Source: Scopus |
