This article is for primary care providers caring for our Medicare Advantage members
This week, we’ll begin sending letters to our Medicare Advantage members who may be due for a colorectal cancer screening to let them know that they’re eligible to receive a Cologuard® kit. Cologuard is a covered, non-invasive screening option that members can complete from the comfort of their home, and is available at $0 copay.
Who is eligible for Cologuard?
Using our claims data, we’ve identified Medicare Advantage members who appear to be due for colorectal cancer screening and may be appropriate for a Cologuard screening1. Cologuard tests are recommended every three years.
How will members receive the kit?
Members who receive the letter are prompted to call Blue Cross and speak with our Engagement Specialist to complete a brief pre-screening to ensure there is no family history or increased risk of colon cancer. Once the member passes this pre-screening, we’ll share their information with Exact Sciences, an independent health screening organization, who will then ship the Cologuard kit2.
If the member does present an increased risk, we’ll point them back to you to review all screening options that are available to them.
How will I get the results?
Exact Sciences will mail results to the member within two weeks after receiving the Cologuard sample. If the member has identified you as their PCP, Exact Sciences will automatically share results with you.
See what we’re sending to members
1INDICATIONS AND IMPORTANT RISK INFORMATION: Cologuard is intended to screen adults 45 years of age and older who are at average risk for colorectal cancer by detecting certain DNA markers and blood in the stool. Cologuard is not a replacement for colonoscopy in high-risk patients. Patients with a positive test result should be referred for colonoscopy. A negative test result does not confirm the absence of cancer. Patients with a negative test result should discuss with their doctor when they need to be tested again.
2 We’re working with Exact Sciences and LifeLine Community Healthcare, an independent health screening organization, to send Cologuard kits to members. Cologuard is shipped through the provider, Exact Sciences who works with clinicians at LifeLine to order Cologuard for the member.