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

Even medical professionals may not understand healthcare pricing

Capitol Imaging Services shares a short story about the misunderstanding that even doctors have about healthcare pricing and costs for patients. On this particular occasion, two physicians told our staff that a local hospital was less expensive than a Capitol Imaging Services affiliate for a particular procedure, a procedure often not covered by insurance. When fully explained by our associates, … Read More

A New Year’s resolution suggestion: ask how much that test will cost!

Would you be upset if you received a medical bill for what most would consider to be an outrageous amount of money for a simple test? That’s what one person experienced with a charge of nearly $12,500 for lab work! This story, published by National Public Radio in December 2020, illustrates the continuing issue in healthcare: exorbitant fees charged by … Read More

One hospital charges $8,000 — another, $38,000

Effective January 1, 2021, a federal rule says hospitals have to list the costs of at least some of their services in accessible, consumer-friendly language. The hope has been that equipped with this information, potential patients can shop around and make a better-informed decision before setting foot in a hospital. It may not always be easy to find these costs, … 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

Can you trust your doctor with your financial health?

That’s a question posed on a website blog that touts services medical cost savings for consumers. It’s an interesting and poignant question. Of course, the presumption is that a person trusts their doctor or medical provider with their physician health, otherwise they would seek different care. We put our trust in their training and expertise to examine, diagnose and treat properly. … Read More

Shop smart for health care: imaging studies

Become an educated consumer. Take ownership in your health care dollar and understand why you were referred to one place over another. Ask your doctor if he or she is required by his or her employer or financially incentivized to send you to a particular medical facility for testing. Look up your imaging study. There are numerous websites that provide estimates … 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

Federal law allows hospitals to charge facility fees

From a story posted locally comes this excerpt: Federal law allows hospitals to charge facility fees for outpatient services at affiliated clinics, regardless of whether the clinic is anywhere near the hospital. The clinics may have the same equipment, staffing and operating expenses as a private practice, and may look much the same as a private practice, but the simple fact that … 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

The difference between hospital based and outpatient imaging

Did you know there is a difference in where you have your medical imaging exam? Most people don’t realize they have the option to visit an outpatient imaging center instead of a hospital for their exam. Or, they don’t understand there is often a big difference. At freestanding outpatient imaging centers such as Capitol Imaging Services affiliates, you can save … Read More

Be a smart shopper on health care

The bane of any purchaser is not knowing enough about the purchase opportunity. We try hard to understand the relationship between price and what we’re getting. Nowhere is this bane more pronounced than in our relationship with our health care system. There are many ways we interface with it: Emergencies — where we ask no questions and simply plead to … Read More

The mistake that can cost you up to 85% MORE for medical tests

Diagnostic tests such as X-rays, CT scans, and MRIs can be very expensive if you don’t have insurance. In fact, they can be expensive even if you DO have insurance, depending on your policy’s deductibles and co-pays. Most people don’t realize that the fees for these procedures can vary tremendously, depending on where they are performed. Many people use hospitals … Read More

Hospital facility fees add to ballooning costs of health care for consumers

Capitol Imaging Services shares this story about ballooning health care costs in the state of Vermont, with one reason being: The root of these increases are controversial charges known as “facility fees,” and they are routinely tacked on to patients’ bills not just for services actually provided in hospitals, but also by outpatient care centers and doctors’ offices simply because … Read More

Cost vs. Convenience — what if you could have both?

Capitol Imaging Services asks the question, “cost versus convenience — what if you could have both?” Which would you rather have in your health care: convenience or low cost? Oftentimes, when choosing one, the other is sacrificed. If you have ever had an x-ray, MRI or CT scan, you are well aware of the expense involved. However, choosing to get … Read More

Another example of hospital imaging MRI exam “sticker shock”

Even though this is not a story from our area, it still holds relevance not only in the greater New Orleans area, but in the southeastern United States as well as the entire country. This story is from a public radio news reporter in Boston, Massachusetts who needed to undergo an MRI (Magnetic Resonance Imaging) scan. The reporter did call … Read More

CPT Codes and why you need to know what they are

Capitol Imaging Services (CIS) has long touted the encouragement for people to inquire and know about the CPT (Current Procedural Terminology) code that pertains to a medical exam, procedure or service that they are recommended to have. However, other national resources are also recommending this to people as healthcare consumers. You have the right to know this code and with … Read More

Your health insurance benefits: things you should know to save money

IF YOUR EXAM IS COVERED BY PRIVATE INSURANCE: To control costs, your insurer negotiates with imaging providers on your behalf for a “contracted rate.” The contracted rate is the maximum amount that an imaging provider can collect for a covered service, and is usually less than the standard charge. What is not widely known is that the contracted rate is … Read More

Share your experiences with the Affordable Care Act

This year, many Americans have signed up for health insurance through the federal or state marketplaces created under the Affordable Care Act. The New York Times and its journalists covering the law would like to hear from people who have this new insurance and whether they are finding it affordable. Click here to participate in this survey.    

Three large insurers join forces for health care price transparency

UnitedHealth Group (UNH) Inc., the largest U.S. health insurer, will lead an industry effort to throw a spotlight on the prices paid for health-care services, making their costs available to consumers on the Internet. The effort, organized by a nonprofit called the Health Care Cost Institute, builds on steps the Obama administration has taken to shed light on prices charged … Read More

Five unpleasant ways employers are cutting back on healthcare costs

The Affordable Care Act, perhaps better known as Obamacare, set in motion a series of changes that are drastically altering the health-services landscape. The law itself was designed for a few purposes. Primarily, it was enacted in order to reduce the amount of uninsured citizens in this country, and to help spread the cost of medical care across a greater … Read More

How to figure out the cost of a medical procedure before it happens

DIS shares an article regarding tips to help people figure out the cost of medical care BEFORE having anything done. It’s a well-written and easy-to-understand guideline that divides healthcare into two distinguished groups:   Routine care Emergency care The first group is fairly easy; the big-ticket stuff, less so, though you can do some things to help yourself. In the … Read More

Study: premiums creep up, higher deductibles jump

Diagnostic Imaging Services shares a news report that highlights while insurance premiums creep up slightly, the out-of-pocket costs for deductibles and other elements not covered by insurance plans are set to significantly jump. DIS assists people with deductibles by offering lower prices on exams than area hospitals and their imaging affiliates. Lower prices translate into lower charges that may be … Read More

What you should know about Magnetic Resonance Imaging

Diagnostic Imaging Services has uploaded a new brochure that will be of great value to people who have been referred for a Magnetic Resonance Imaging (MRI) exam, but have never had one before. Our “What you should know” literature is designed to take some of the mystery out of having an MRI. By knowing more information before you visit one … Read More

Confusion and misinformation abounds regarding screening mammograms

In recent weeks, DIS has heard from women who claim that screening mammograms are “free”. This statement may be technically true, but for specific reasons. If a woman has insurance coverage, per the Affordable Care Act, a screening mammogram is covered at 100 percent. However, if a woman is uninsured, in the vast majority of instances, a screening mammogram needs … Read More

What questions should you ask when evaluating health insurance plans?

Soon, if not already, many of you will be selecting your health insurance choice for 2015, a choice that impacts yourself as well as anyone else that will be included in the insurance plan. Insurance can be confusing no doubt about it. But DIs shares a short video that outlines five recommended questions to ask when evaluating plans. The future … Read More

Employer health plan deductibles see big 5-year jump

DIS shares a USA Today news story from September on a report that indicates health insurance deductibles taking a huge jump as we head into 2015. Premiums for employer-paid insurance are up 3% this year, but deductibles are up nearly 50% since 2009, the report by the Kaiser Family Foundation shows. The average deductible this year is $1,217, up from … Read More

Insurance out-of-pocket costs can be reduced by using outpatient imaging!

Diagnostic Imaging Services shares a video from a medical doctor who explains the conundrum a patient of his had when the doctor recommended a CT scan. In this example, even with health insurance, the patient had an opportunity to pay nearly 1/3 less to an independent outpatient imaging center, that in the words of the doctor, “does perfectly good CAT scans.” Kudos to … Read More

How much difference in price is there between hospital imaging and DIS?

It can be a complicated and somewhat cumbersome task to try to find and then understand the information published by the federal government regarding reported submitted charges for certain imaging procedures by local hospitals. However, that’s why DIS is here to try to simplify the information so you can make informed choices! If you visit the Centers for Medicare and … Read More

More employers moving toward high deductible health plans — the time is NOW to become savvy consumers!

Many Americans with job-based health insurance will face costlier deductibles in 2015 as more large employers embrace or expand so-called consumer-directed health plans, a new survey finds. The shift to high-deductible, consumer-directed health plans is occurring as Fortune 500 companies and large public-sector employers grapple with rising health-care and insurance costs. “Employers are looking to put their employees in the driver’s … Read More

Average submitted charge for MRI without the use of a dye? Compare here…

As part of overall health care reform, there is more information being published for public consumption that identifies charges by hospitals across the country for various services, both inpatient and outpatient. Unfortunately, often times this information is convoluted, difficult to find and even more difficult to understand. That’s where we come in. Below is information reported by the Centers for Medicare & … Read More

Published research shows hospital-owned physician groups have 20% higher medical costs

As hospital systems nationwide acquire more physician practices, everybody may be getting hurt. A new study published in The Journal of the American Medical Association shows that hospital ownership of physician groups in California led to up to 20% overall higher costs for patient care. Employers and workers have to pay for these increased costs in the form of higher premiums, and … Read More

News report: Americans have insurance — but can’t afford to use it

Although more Americans have health insurance coverage, 25 percent of non-elderly Americans don’t have enough liquid assets to cover the deductible on their health insurance plan, according to a new report from the Kaiser Family Foundation. The report finds that many consumers don’t have the cash on hand to cover the cost of a mid-range deductible or $1,200 for an … Read More

The fee for not having health insurance “soars” in 2015

Diagnostic Imaging Services shares a news report on the significant increase in the penalty that will be levied on those people who do not have health insurance. According to the report, the maximum penalty per family in 2014 looks like a bargain now at $285, a hike of nearly 250%. The fee will continue to get stiffer in 2015 when it … Read More

Hmmmm… interesting

Recently, a person living in the greater New Orleans area used our online appointment request tool to send us an email to have us contact her to schedule an ultrasound. The interesting thing? This person works for a local hospital. Even hospital employees know the advantages of visiting Diagnostic Imaging Services. Say YES. Spend LESS.

Prices for over 70 medical procedures are now online

Buying health care in America is like shopping blindfolded at Macy’s and getting the bill months after you leave the store, Princeton economist Uwe Reinhardt likes to say. But an online tool that went live in February is supposed to help change that, giving patients in most parts of the country a small peek at the prices of medical tests and … Read More

Data shows large rise in list prices at hospitals

Diagnostic Imaging Services shares a news report showing that list prices at hospitals across the United States have risen at a pace that outpaces inflation. Most people with health insurance, including those receiving Medicare, won’t ever a see a bill for the hospital’s list price because the insurer negotiates a lower rate. But these rising charges are a growing concern … Read More

Have you spoken with your benefits value advisor?

Do you know if you have one? For many health insurance carriers, members (i.e. policy holders) can usually call or email an advisor that will assist in identifying benefits information, cost estimates and information on in-network providers for health care services. For services including surgeries, specialty procedures AND medical imaging tests such as MRI or CT scans, advisors can be … Read More

Attention all savers!

Diagnostic Imaging Services believes we will save people money on their imaging exams while providing the same, if not better, quality of care. How is that possible? Click on the picture to find out more.  

Don’t believe “your insurance will pay for it”

Diagnostic Imaging Services shares the experience of one woman who wrote an October 2014 piece for Forbes magazine. As many discover — and DIS has warned — trying to find the TRUE cost of an imaging exam such as an MRI is much more time-consuming that it should be. Because of the convolution of prices that DIS refers to as … Read More

Another example of the higher cost of hospital imaging exams

Diagnostic Imaging Services received this copy from a woman who visited a New Orleans area hospital for an ultrasound of the abdomen. DIS performs two ultrasounds of the abdomen: CPT code 76700 abdominal complete CPT code 76705 abdominal limited As you can see from the image, the radiology charge from the hospital was $1,224.00. DIS performs CPT code 76700 with … Read More

Tips for talking to your doctor about price

Taking an active role in your health and communicating with your doctor is critical to getting good healthcare; that includes discussions around cost. Here are some tips on preparing for discussions with your doctor about price. Get educated. Before you go to your appointment, become familiar with your health plan. Find out about your co-pay, deductible and what procedures are … Read More

Over 17 million enrolled in high deductible health insurance plans

An annual census conducted by America’s Health Insurance Plans (AHIP) of U.S. health insurance companies shows that enrollment in health savings account/high-deductible health plans (HSA/HDHPs) totaled 17.4 million in January 2014. The number of enrollees with HSA/HDHPs rose to nearly 17.4 million in January 2014, up from 15.5 million in January 2013, 13.5 million in January 2012 and 11.4 million in January 2011; an average … Read More

Hospital employment of doctors rising rapidly

The number of physician practices owned by hospitals and health systems jumped 86% from 2012 to 2015, according to a survey conducted by the Avalere Health for the Physicians Advocacy Institute (PAI). The number of physicians employed by hospitals increased by nearly 50% during the same period, from 95,000 doctors in 2012 to more than 140,000 physicians in 2015, the … Read More