If you want information about saving money DIRECTLY from a person who works in the health care field, this presentation is for you!
It really isn’t that difficult. There are a few key words she gives to guide you to where you want to be.
Step 1: Find out what type of test you are ordered to have.
In this example, she would have been able to get the CPT (Current Procedural Terminology) code from her doctor. The CPT code is a five character code used in billing for the test. For instance, one MRI code is 72141, an MRI of the cervical spine without the use of a contrast dye.
Step #2: Call your insurance company and ask the questions:
- Is this a covered service?
- If yes, what facilities are in network?
Step 3: Call the different facilities and ask what their coverage is for that particular service.
- What is the dollar amount you receive from my insurance for this type of procedure?
- This dollar amount can be very different from facility to facility.
- This amount is what you will pay if deductible isn’t meet at all, this is also the “magic number” that your 20% or 30% will come out of.
Ask the office “does this test it hit my deductible”?
- Yes or no (if yes, then you pay the dollar amount before your insurance will pay anything; if no, then you do not have to pay any of this $ amount).
- Ask is it covered at 100% or 80/20 or 70/30 etc. (Co-insurance)?
- This means that if your “magic number” is $1,500.00 then you will be responsible to pay 20% or 30% of that magic number, etc.
Does it cost a co-pay?
- Co-Pay is a small amount but it is quite common for this charge; just don’t want to leave it out as it is part of the cost incurred with these types of diagnostics.
Her events that caused her to pay such close attention to the mentioned “key words” was an experience with a MRI test.
Listen to her story below and you might be VERY SURPRISED as to what a health care professional learned when comparing what she would have paid at a hospital for the MRI as compared to an independent outpatient imaging provider — a provider similar to Diagnostic Imaging Services.
As we have said many times, know before you go! Her story of savings was made possible because she took the time to call and ask the right questions. If you can’t get the answers to your questions, ask yourself, “Do I really want to go there?”
In this particular situation, the need for the MRI was not an emergency, so there was not necessary to go to the hospital. Another question you might want to ask yourself is, “Why would my doctor tell me to go to a hospital and not know that my costs could be so much more?”
Good question. Don’t be afraid to ask! The doctor is human. He or she may not be aware. Make them aware. It’s your money. It’s your health care. It’s your choice.