Submitted by Peoria Imaging
With the world of health care and insurance ever changing and costs skyrocketing, it is important to educate yourself. Americans are paying a larger portion of their health care costs than they used to whether they are accessing insurance through an employer, the state exchange or from an insurance company. Higher premiums along with rising deductibles have become very real in recent years, while provider networks seem to be shrinking. Out-of-pocket costs could be minimized by becoming more educated.
Let’s take, for example, diagnostic testing: MRI, CT, ultrasound and X-ray. These can be very expensive tests even with insurance, depending on co-pays and deductibles. In fact, diagnostic testing accounts for 57 percent of cancer costs (2010 report in JAMA). Most people do not realize that the fees for these procedures can vary tremendously depending on where they are performed. Due to the lack of knowledge that there are other choices, or simply due to just old habits, most individuals choose local hospitals for outpatient procedures and diagnostic testing. But, it’s good to shop around and see if there are other options.
Imagine going to the local grocery store to pick up a gallon of milk. Instead of paying up front, and checking on the price, you decide to have the store bill you at a later time. Weeks later a bill arrives for $19.99 for that gallon of milk. The price could have ranged from $3.00 to $20.00. Similar things are occurring in our medical system; an MRI could cost $3,500 at one facility and $1,500 at another. It is important that we educate ourselves and know that there could be other options to reduce our health care cost.
Because insurance companies are shrinking their networks, one of the most expensive mistakes a person can make is to seek health care out of a health plan’s network. However, finding an independent option for something like diagnostic testing could save hundreds even thousands of dollars. Educate yourself on the facilities and physicians in your plan’s network. Some insurance companies have online tools to help find in-network facilities and providers. Call your insurance company as well as your provider to verify that they are in-network. Or, if you have a higher deductible, call and ask if the company or hospital offers a cash rate and what that cash rate includes. Preferred Provider Organizations (PPOs) usually allow individuals to utilize out-of-network doctors/facilities and charge higher co-payments or coinsurance rates, for example: 50 percent out-of-network, 10 percent in-network. However, if you have an HMO (Health Maintenance Organization), you may only have out-of-network coverage in the case of an emergency. It is important to know what and who your plan covers.
If you decide to call around and shop for your next diagnostic test, here are some questions that you may want to ask:
- Is the price of the radiologist fee included in the price of the scan at your facility? This is called global billing.
- Is there a discounted cash rate offered at time of service?
- Will the cash rate go towards my insurance deductible?
- What is the cost difference between “at-time-of-service” cash rate and my insurance discounted rate?
- Does your facility offer special 0 percent financing to spread the payments out over a few months?
- If your facility is out-of-network with my insurance plan, can I still be seen?
- For out-of-network services, will a contracted rate be given and will my insurance be billed?
If the provider is unable to answer these questions, you may want to consider shopping around, or contact your insurance for other possible choices.
In an article written by Dr. Mercola regarding “costly healthcare mistakes,” he certainly drives home the point that consumers need to educate themselves when it comes to their health care and their health care options. “Many consumers will check half a dozen gas stations for a few cents difference in price, but would never think they could save thousands of dollars by checking prices for a medical test like an MRI.”
You have a choice in selecting your radiology imaging services: MRI, CT, ultrasound and X-ray. Peoria Imaging is conveniently located at 6708 North Knoxville Avenue in Peoria, IL. Most insurance is accepted along with Medicare, Medicaid and workers compensation claims, with competitive cash rates. Call today at 309-692-7674 for your free, no obligation price quote or to make an appointment.