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

Another recommendation to shop around for healthcare services

Capitol Imaging Services has and will continue to trumpet the cause for people to stop being passive patients and start being active consumers. This means standing up for themselves when discussing options for healthcare services with their provider. Often, a provider, particularly if they are employed by a hospital or health system, will direct you there, regardless of cost to … 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

You better shop around

Whether you have health insurance that included a deductible — and often those deductibles extend into the thousands of dollars — or if you uninsured, an exam cost can be daunting for most. However, by being smart and comparing prices (and yes, it will take time and effort, but if saving significant money is your goal, the investment in perseverance … 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

Cost and convenience at Capitol Imaging Services

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 your scans done outside of a hospital could save you big bucks. Hospital radiology departments can … 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

Patient: “I see no reason to pay three times the price”

As Capitol Imaging Services helps more and more people save significant amounts of money on healthcare, we wanted to share insight from a person who recently contacted us to compare our fee for a test with the fee of a local hospital. We were not surprised at the results. Hospital: triple the rate This person received a recommendation to have … 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

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

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

Obamacare fee of $63 per person to begin in 2014

From an online news article posted this week: Your medical plan is facing an unexpected expense, so you probably are, too. It’s a new, $63-per-head fee to cushion the cost of covering people with pre-existing conditions under President Obama’s health care overhaul. The charge, buried in a recent regulation, works out to tens of millions of dollars for the largest … Read More

More Health-Law Changes Coming in 2013

Most of the really big changes—including health-insurance exchanges and tax credits to help people buy coverage—aren’t coming into play until 2014. Still, the provisions going into effect in 2013, along with those that have already been introduced, can affect any changes you might want to make to your health coverage. Next year will see some of the many significant changes … Read More

D.I.S. adds two new insurance plans to its list of accepted coverages

Diagnostic Imaging Services announces the addition of two health insurance plans that are accepted for coverage of imaging exams: Medicaid – LaCare United Healthcare – PCIP (Pre Existing Condition Insurance Plan) LaCare is a program of AmeriHealth of Louisiana, Inc. and part of the AmeriHealth Family of Companies, one of the largest organizations of Medicaid managed care plans in the … Read More

When medical bills hurt your credit

You may not know about health care bills sent to collections, but they can really hit your credit scores. D.I.S. shares an article about advice on how to protect yourself and your credit. https://money.msn.com/credit-rating/when-medical-bills-hurt-your-credit?ocid=vt_twmsnmon At Diagnostic Imaging Services, we will do everything we can to work with you for any financial obligations you may incur for your imaging exam. We … Read More

Expected price of Obamacare mounts

With many Americans and businesses concerned about the impact of Obamacare, a new study from the country’s top group of financial risk analysts is providing fodder for those fears. Underlying claims costs — which form the basis for insurers’ health care coverage premiums — will jump by one-third across the U.S. after the Affordable Care Act goes into effect next … Read More

Obama Budget Replaces Sequester Cuts and Sustainable Growth Rate

Medscape Medical News – Robert Lowes, April 10, 2013 President Barack Obama today released a proposed $3.8 trillion budget for fiscal 2014 that would shrink the federal deficit by $1.8 trillion over the course of 10 years, but not on the backs of physicians. Instead, they are on the receiving end of some federal largesse. For starters, Obama’s deficit reduction, similar to … Read More

Millions can’t afford to go to the doctor

The number of working-age adults in 2012 who skipped needed care because of cost: Did not visit a doctor: 53 million Did not fill a prescription: 50 million Skipped recommended care: 49 million Some 80 million people, around 43% of America’s working-age adults, didn’t go to the doctor or access other medical services last year because of the cost, according … Read More

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

Consumers on May 22, 2013 will finally get some answers about one of modern life’s most persistent mysteries: how much medical care actually costs. For the first time, the federal government will release the prices that hospitals charge for the 100 most common inpatient procedures. Until now, these charges have been closely held by facilities that see a competitive advantage in shielding … Read More

Learn the difference between DIS and hospital imaging centers

Diagnostic Imaging Services is an independent freestanding outpatient imaging company serving the greater New Orleans area. To the vast majority of the general public, there may not be any difference between us and another organization offering similar services. But, there is a HUGE difference between DIS and hospital imaging centers. Click on the below to watch our presentation and learn … Read More

New Health-Care Law’s Success Rests on the Young

By Christopher Weaver and Louise Radnofsky | The Wall Street Journal PORTLAND, Ore.—The success of the new health-care law rides in large measure on whether young, healthy people like Gabe Meiffren, a cook at a Korean-Hawaiian food cart, decide to give up a chunk of disposable income to pay for insurance. After getting a peek at rates being offered for fall, the 25-year-old … Read More

More Doctors Steer Clear of Medicare

By Melinda Beck | The Wall Street Journal Fewer American doctors are treating patients enrolled in the Medicare health program for seniors, reflecting frustration with its payment rates and pushback against mounting rules, according to health experts. The number of doctors who opted out of Medicare last year, while a small proportion of the nation’s health professionals, nearly tripled from … Read More

Get ready for enrollment in health exchanges

by KRISTEN GERENCHER, The Wall Street Journal In about six weeks, Americans will have a new kind of open enrollment to consider. Starting October 1, 2013, people without health insurance can sign up for standardized coverage through new health-insurance marketplaces run either by their state, the federal government or a combination of the two—the centerpiece of the Patient Protection and … Read More

Americans don’t understand insurance, let alone Obamacare, research shows

Forbes — Steve Japsen, Contributor, August 10, 2013 With open enrollment for uninsured individuals to buy health coverage under the Affordable Care Act set to begin in less than two months, research is mounting that shows consumers don’t understand health insurance, let alone key aspects of the landmark health law. The studies are troubling, researchers say, particularly when there are … Read More

Hospitals buying more doctors’ practices

The below is an article published online by USA Today, regarding the trend found in the South Carolina area. Another reason hospitals are employing more doctors is to get their referrals, said Lynn Bailey, a health care consultant in Columbia, S.C. Having the physicians as well as home-health agencies, transportation, rehabilitation, medical equipment and other services makes hospitals the dominant … Read More

In the case of Obamacare, no news isn’t good news

So far, seventeen states plus the District of Columbia have publicly released data on rates consumers will pay for policies offered on the Affordable Care Act’s online marketplaces, including eleven states operating their own exchanges and seven defaulting to a federally-facilitated exchange. California said premiums would increase, on average, by 26.5 percent, while Ohio quoted a 44 percent increase and New York … Read More

Prices set for new health care exchanges

By Louise Radnofsky | The Wall Street Journal — U.S. officials for the first time disclosed insurance prices that will be offered through new federally run health-care exchanges starting Oct. 1, showing that young, healthy buyers likely will pay more than they do currently while older, sicker consumers should get a break. The plans, offered under the health-care overhaul to people who don’t get … Read More

How health care reform saved a life and a ton of insurance money all at once

LifeHealthPro chief editor Bill Coffin wrote about his friend Amy (not her real name) and how her successful battle with breast cancer was made easier by health care reform. Numerous readers responded to the article, and not always favorably. Rather than answer such responses himself, Bill thought that perhaps Amy could do a better job of it. To read Amy’s story, … Read More

An overview of what people are recommended to know about ACA rollout

By Tracy Connor, Staff Writer, NBC News President Barack Obama says no one is more upset than he is with the glitches that have hampered open-enrollment in the Affordable Care Act — but some Americans who have tried time after time to sign up might disagree. Three weeks into a six-month signup period, the federal website created to allow the … 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. To read of the experience, … Read More

If 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

Secret pricing spikes US healthcare costs

Washington (AFP) – Secret pricing is making healthcare in the United States more expensive than ever, leading costs to triple in the past two decades, experts said Tuesday. Overall, US healthcare costs now account for nearly 18 percent of gross domestic product (GDP), twice the amount spent by Japan, Ireland and Sweden where people are generally healthier and live longer. … 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

U.S. health care lags behind other affluent countries, study finds

WEDNESDAY, Nov. 13 (HealthDay News) — American adults are far more likely than those in 10 other high-income countries to go without health care due to cost, or to have trouble paying their medical bills, a new study finds. The study, from independent think tank The Commonwealth Fund, also found more Americans complaining of hassles over health insurance disputes and … 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

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

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

Comparing hospital Medicare provider charge data with DIS

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 and Magnetic Resonance Angiography of the head and neck without a contrast dye. Here is a breakdown … Read More