Arm yourself and know your CPT code

Arm yourself with an important piece of information for a medical service — the CPT code. CPT stands for Current Procedural Terminology, which is used universally across all medical and health providers.  With this code, you can contact multiple providers in order to better compare costs BEFORE you have any service done. Take control. It’s your money. It’s your health … Read More

Doctors shun patients who pay with Medicaid

Most doctors in private practice lose money on Medicaid patients, because the program pays less than commercial health plans or Medicare, the federal insurance program for Americans over 65. Many physicians already don’t accept Medicaid, and millions of new enrollees clamoring for appointments will strain those who do. About 46 percent of physicians accept Medicaid, according to a 15-city survey last … Read More

Patients often win if they appeal a denied health claim

Federal rules ensure that none of the millions of people who signed up for Obamacare can be denied insurance — but there is no guarantee that all health services will be covered. To help make sure a patient’s claims aren’t improperly denied, the Affordable Care Act creates national standards allowing appeals to the insurer and, if necessary, to a third-party reviewer. … Read More

Health law sign-ups on track to hit 7 million

WASHINGTON (AP) — Beating expectations, President Barack Obama’s health care overhaul was on track to sign up more than 7 million Americans for health insurance on deadline day Monday, government officials told The Associated Press. The 7 million target, thought to be out of reach by most experts, was in sight on a day that saw surging consumer interest as … Read More

Obamacare website fails as deadline arrives

People trying to apply and enroll for private health insurance through Obamacare before Monday’s midnight deadline discovered the website was “currently unavailable.” Healthcare.gov, the online marketplace bedeviled by bugs since its launch last fall, went down for several hours Monday morning, a statement from the Department of Health and Human Services said. It was back online later in the morning … Read More

Comparing hospital Medicare provider charge data with Capitol Imaging Services

On the Centers for Medicare and Medicaid services, there is data posted on hospital-specific charges for 30 Ambulatory Payment Classification Groups (APC) paid under the Medicare Outpatient Prospective Payment System for calendar year 2011.  One APC code reported is 0336 – Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) of the head and neck without a contrast dye. Here … Read More

An “uncovered” hidden Obamacare cost

November 30 has come and gone, meaning HealthCare.gov, the $630 million portal created by the Affordable Care Act that links all 36 federal online insurance marketplaces, should be running smoothly for the majority of users. However, that does not mean the marketplaces are easy to use, especially for individuals trying to compare how different policies cover drug costs. Costs can differ … Read More

States losing billions in refusing to expand Medicaid, report finds

Texas will lose $9.2 billion in 2022; Florida says goodbye to $5 billion; Georgia is out $4.9 billion. A new report details just how much states are losing because they don’t want to expand Medicaid under Obamacare, and it’s not chump change. Red states may be sticking to their Republican beliefs in small government, but the Commonwealth Fund finds they … Read More

Companies prepare to pass more health costs to workers

Companies are bracing for an influx of participants in their insurance plans due to the health-care overhaul, adding to pressure to shift more of the cost of coverage to employees. Many employers are betting that the Affordable Care Act’s requirement that all Americans have health insurance starting in 2014 will bring more people into their plans who have previously opted … Read More

Who gets a subsidy under the Patient Protection and Affordable Care Act?

The new availability of tax credits for qualified low-income people purchasing individual coverage through exchanges could be a game changer. Qualified individuals with family incomes between 100% and 400% of the Federal Poverty Level (FPL) will be eligible for sliding-scale premium tax credits that will cap the amount they may pay for coverage. Individuals with family incomes at or below … Read More

Caught between the hospital-insurance crossfire

When you’re in recovery from a hospital visit — whether it’s a major surgery, a visit to the emergency room or just a routine procedure — the last thing you want to worry about is paying your medical bills. Although the doctors may have stitched you up, sometimes they don’t quite stick to procedure when it comes to filing your … Read More

Sharing a journalist’s experience with the federal government health care website

A reporter documents their experience with researching health insurance options. The success achieved in getting the information was not through the website, but by utilizing a toll free number in order to speak to a representative. For those who are having difficulties with the online application process, the telephone may be your next best option. While the digital age has … Read More

What is global billing?

There are many confusing terms surrounding healthcare, healthcare services and health insurance coverage. Numerous different options can often put someone’s head in a spin as they try to grasp with bills and statements from medical provider offices, hospitals and medical centers. One term that Capitol Imaging Services often uses and can be considered to be a major financial benefit to … Read More

Have a High Deductible Health Insurance plan?

According to the website, www.valuepenguin.com, “high-deductible health plans (HDHPs) were created for consumers to have a health insurance option with lower premiums and high deductibles. These plans can be linked to health savings accounts (HSAs) to pay for qualified medical expenses in a tax-advantaged way.” As we have made our way through the first two decades of the 21st century, … Read More

Millions can’t afford to go to the doctor

Nearly one-third of Americans skipped needed medical care in the past three months due to cost. Even about 20% of the nation’s highest-income households, those earning more than $120,000 per year, blame cost as the reason for not seeking care, up from 3% over the same timeframe. An estimated 150 million Americans say they are now more worried about the … Read More

Three components: patient, doctor and insurance provider

Let’s talk about a term that may be unfamiliar to many people but may cause lots and lots of confusion, aggravation and stress: medical necessity. Medical necessity is defined as “accepted health care services and supplies provided by health care entities, appropriate to the evaluation and treatment of a disease, condition, illness or injury and consistent with the applicable standard … Read More

Hospitals tend to be compensated by insurance companies at about twice the rate for private independent companies

The headline is a statement made in an article posted in the Southwest Citizen’s Guide on patient comparison shopping for imaging services. Often, the follow-up question most will ask is “Why?” Common reasons include: Hospitals often negotiate with insurers for higher reimbursement rates on their imaging services. Hospitals claim they need higher reimbursements due to their large overhead and to compensate … Read More

Insurance deductible, coinsurance, and copay: know the differences

Many people are confused about the differences between an insurance deductible, co-pay and coinsurance. In short, all three represent the portion of the medical bill that you are responsible for in case you get sick or injured. Another term used is out-of-pocket expense. However, there are some very unique differences between each one. Deductible An insurance deductible is usually a … Read More

Health insurance company begins shopper program

Blue Cross and Blue Shield of Louisiana is rolling out a shopper program that “allows members to choose, based on quality and cost, the diagnostic imaging facility where their services are rendered.” Beginning July 1, 2017, the AIM Specialty Care Shopper program introduced to their individual Preferred Care PPO and HMO Louisiana, Inc. members for Magnetic Resonance Imaging (MRI) and … Read More

Insurance company takes aim at hospital outpatient imaging tests

Anthem, often called a “Blues giant,” has taken a strike against healthcare services that are provided in a hospital when the same services could be performed in an independent non-hospital outpatient setting and at lower rates. Anthem is not a health insurance carrier in Louisiana. However, it will be interesting to see how other insurance providers, as well as hospitals … Read More

Report cites “out of pocket” health spending is soaring

According to a research report published, U.S. health care spending increased to $3.3 trillion in 2016, with out-of-pocket health care costs borne directly by consumers rising 3.9 percent – the fastest rate of growth since 2007. Published by the non-profit organization, Health Affairs, health expenditures swallowed a greater part of the economy, with health expenditures making up 17.9 percent share … Read More

Health insurance terms explained

Capitol Imaging Services shares a very informative article that “simply” explains terms we hear or come across in regards to our health insurance. Insurance can be confusing and sometimes frustrating thing to understand, and often people throw up their hands in frustration. Use this article to become a bit better informed. Capitol Imaging Services associates are experienced, knowledgeable professionals who … Read More

Sky high deductibles broke the US health insurance system

The above is a headline on a recent news feature published by Bloomberg, a major publisher in the business and financial market sectors. According to the feature’s authors, 39 percent of large employers offer only high-deductible plans, up from 7 percent in 2009, according to a survey by the National Business Group on Health. Half of all workers now have … Read More

Medicare and Managed Medicare health insurance now cover 3D mammography

Women with Medicare and Managed Medicare plans (i.e. Humana Gold, Choices 65, etc.) can choose the 3D mammography option for their screening without any additional fees. For nearly four years, these plans also cover 3D in addition to the traditional portion of their mammogram. 3D mammography is also known as breast tomosynthesis. There are several additional health insurance plan types … Read More

Four money saving questions to ask every medical service provider

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 … Read More