However, we suspect most everyone is price-conscience or price-sensitive, often the same thing. No one wants to pay more than they have to and in the area of healthcare, often that ends up being the case — particularly in medical imaging.
Here are four pointers suggested by people who were patients themselves and underwent an imaging exam.
- Insurance companies negotiate different rates with different hospitals. However, it is often, if not always, a very hard time getting hospitals or doctors employed by hospitals to give me the negotiated rate. An insurance provider such may tell you if you’re willing to wait on hold and have the exact code for the exact procedure I need.
- Get the code for the test of procedure you need. In some cases there will be several billing codes. For example, if a person who underwent an MRI study of the brain, the code for the study would either be 70551 for an MRI without the use of a contrast dye or 70552 if contrast is used. Those numbers may be used in so many different conversations, you may not ever forget them. However, they are EXTREMELY IMPORTANT to have when comparison shopping.
- Sometimes your insurance company will send you the Explanation of Benefits (EOB) that lists the price they actually pay the hospital, but deciphering all this paperwork and jargon is similar to trying to understand a foreign language.
- The radiology charge is often a separate bill at a hospital, or rather two bills: what the doc charges and what the insurance company pays. Always ask lots of questions and make sure you get the name (first and last) of the person with whom you are speaking, in case you want to go back and review after your test is done and there is a discrepancy.
So, why the huge disparity between charges for an MRI performed at a hospital when compared to a stand-alone clinic such as Diagnostic Imaging Services? Hospitals have said that it costs a lot to keep a hospital open 24 hours a day. Hospitals report losing lots of money on some services and make it up in other areas such as imaging. MRIs or other tests are a place that they often make up for money lost on services such as emergence rooms.
Hospitals also claim they lose money taking care of patients with Medicare — that’s mostly for the elderly — or Medicaid — the government insurance mostly for low income individuals. So, private insurance payers (those without Medicare or Medicaid) end up paying more for these tests so that the hospitals can have everything supposedly balance in the end.
However, charging more for an MRI to make up for losing money on other services is just a sign that health care finances are really broken. A reimbursement for diagnostic imaging at a very high rate to justify the underpayment for other lines of health care is like justifying the $500 Ace bandage.
The logic isn’t there.
When you choose Diagnostic Imaging Services, we do everything we can to provide you with the information needed to identify prices and any potential costs you would have to pay when insurance not cover the entire cost or there is an unfulfilled deductible. At DIS, it is one fee for all services. You don’t receive multiple charges. Everything is included:
- The use of our center
- The utilization of our technology
- The medical interpretation and report issued by the radiologist
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