Healthcare Consumers Save With a Shift to Outpatient Care
May 02, 2018
Submitted by Melissa Marx, Administrator, Ft. Jesse Imaging Center
People easily panic at the unknown costs of required medical care. In today’s rapidly changing health care environment, it is difficult to know whether the procedure(s), physician, or care facility is included as part of your insurance coverage. Even if a procedure is covered, there is likely to be an out-of-pocket expense as part of most health insurance plans.
As a consumer of healthcare services, the responsibility to understand your individual coverage, the cost of your providers, and expenses of your exams now rests squarely on your shoulders. Most people, however, are not aware that managing the expenses of health care services can be as simple as shopping around for the best value.
Insurance companies base the rates they charge, in part, on the costs they pay out on your behalf. By taking time and energy to shop for the best prices now, healthcare consumers can save money on their insurance premiums for years to come.
To help you get started, here are some questions you can ask your providers as you navigate your healthcare options.
Are you in-network?
In-network providers have negotiated lower rates with the insurance company to provide services. Networks change often, so be sure to check every time to avoid an unexpected and costly out-of-pocket expense. If services of a specialist are recommended, ask about billing and insurance coverage:
How will I be billed?
- Which doctors will be involved in the treatment plan? Are each of those doctors in-network?
- Does the cost of this treatment apply toward your deductible?
- Is there a price difference if the test is performed at an outpatient clinic instead of a hospital? Imaging services, like MRI, CT or
- X-ray are often less expensive at an outpatient clinic
- Ask if the outpatient facility offers global billing, which allows charges from your visit to be billed as one charge. For example, you will not receive one bill for the radiologist reading and another for the facility.
- Is there a discount for self-pay patients or for paying cash at the time of service?
- Are there options for setting up a payment plan?
The development of outpatient centers around the country and right here in Central Illinois, are helping to combat the high costs of healthcare. Many insurance carriers have education programs to help their members find high quality, affordable care.
Most insurance companies make it easy to find in-network healthcare providers on their website. They often offer cost estimator tools for healthcare consumers. These tools allow patients to search by exam type, facility location, and expected cost of the exam.
Amy Jeffreys, Practice Liaison at Fort Jesse Imaging Center says that, “When talking with consumers at community events, I always encourage them to contact their insurance company or call facilities directly to inquire about pricing. In most cases, patients have a choice which could save them hundreds of dollars.”
Outlined below are some of the reasons outpatient centers are experiencing tremendous growth.
- Convenience — Outpatient centers are conveniently located in areas easily accessible to both patients and their physicians. Due to operational efficiencies, these centers provide a full range of services at a lower cost than traditional healthcare settings.
- Scheduling — Outpatient centers run on a daily schedule and can limit patient wait times. For example, when waiting for an MRI, you won’t be in line behind critical care cases and other add-on exams for patients staying in the hospital or receiving urgent care. Outpatient imaging centers can provide same or next day scheduling including Saturday appointments.
- Reimbursement — Outpatient care centers are a fraction of the cost of traditional healthcare in part due to lower overhead and more effective scheduling of exams. Insurance companies in turn benefit from these operational efficiencies, which lower the cost of expenses paid by patients directly.
It’s important to remember the purpose of insurance coverage is to spread the risk of paying for medical events over many people. By managing your individual health care costs and taking care of your own health, you are also helping to manage the expenses of healthcare for everyone in the future.
Set yourself up for success — these suggestions offer a great place to start:
- Eat right, exercise, do not smoke
- Take advantage of preventative services, annual wellness checks, and annual mammograms for women
- Do your best to prevent medical conditions that will require expensive treatments
- If you have insurance coverage through your employer, set up a Health Savings Account (HSA) or a Flexible Spending Account (FSA)
- HSAs help fill the gap if you have a high-deductible medical plan
- FSAs allow you to pay for qualified medical expenses using money you saved tax-free
- If you are currently uninsured, investigate your options under the Affordable Care Act (ACA). Whenever you stand on the politics of the ACA, you’re better off having some insurance coverage rather than none
- Inquire about uninsured rates and payment plan options at medical facilities
Ultimately, it is up to you to manage your health care plan and all the financial concerns surrounding your coverage. Remember, you have a choice when selecting your health care providers, so choose wisely.
Fort Jesse Imaging, located at 2200 Ft. Jesse Road, Suite 120 & 130 in Normal, is the only multi-modality outpatient medical imaging facility in McLean County. They offer uninsured rates, payment plans, global billing and lower prices combined with a full line of imaging modalities. The friendly staff at Fort Jesse Imaging are experienced in verifying insurance coverage and clearly communicating to patients the cost of their exams. For more information, you may call 309-454-5552 or visit www.ftjesse.com.
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