How To Avoid A Surprise Bill For Your MRI or CT

Surprises on your birthday are one thing. Surprises that come in the form of a bill in your mailbox are another. Nobody likes to open an envelope, unfold an invoice, and get surprised.

“One of the top questions I am asked is regarding price quotes. How much is this going to cost? Is my insurance going to cover it?” says Alyssa Cloninger, Insurance Supervisor and Patient Advocate at Froedtert and the Medical College of Wisconsin RAYUS Radiology.

Did you know that we can give you an estimate for your exam when you call to book an appointment or when you come in to visit one of our centers?

Getting an Estimate

When it comes to diagnostic imaging, cost is important and so is quality. Our goal is to provide you the best value by providing the highest-quality answers and service at a more affordable cost.

Are you alone in asking how much it will cost? “No!” says Randi Klein, RAYUS Radiology Director of Revenue Cycle operations. The majority of patients ask for an estimate.

“There are a number of factors that going into providing an estimate, including whether your exam requires contrast or not,” Randi explains. “Other factors such as your insurance deductible and out-of-pocket maximums can also impact the final cost of your exam.”

Is My Insurance Accepted?

We do accept most major insurance plans, including auto accident, workers’ compensation and government-funded programs. In most cases, we are an in-network provider, but please refer to your health plan information to confirm your coverage and requirements for pre-authorization.

To find out more about in-network and out-of-network coverage click here.

Specific questions regarding your policy and coverage should be directed to your insurance carrier as insurance plans and benefits vary widely. Especially if you have a high-deductible plan or are planning to self-pay, getting an estimate in advance will let you know exactly what to expect.

“We really try to promote patients being an advocate for themselves and contacting their insurance company,” says RAYUS Insurance Specialist Abi Roberts. You can ask your insurance company if there are authorization requirements and ask about your deductible. “It’s as simple as calling that customer service number on the back of your insurance card. They want to help you.”

Understanding the Costs

If you are comparing costs with other imaging centers, be sure to ask if you will receive one global bill or two separate bills. “We don’t want it to be a mystery,” says Abi. “I want patients to know what they’re looking at cost-wise.”

For imaging exams there is a technical fee for the imaging as well as a professional fee for the radiologist to review your images and write a report for the doctor who referred you for imaging.

Some centers send one ‘global’ bill that includes the technical fee and professional fee, while others send two separate bills. It is important to ask what charges make up your estimate and if it includes both fees. Our estimates always include both fees.

For 3 Tips on navigating the insurance system click here.

Can my Estimate Change?

Your price estimate is not a guarantee. If your insurance coverage or your deductible changes between the time you get your estimate and when you have your appointment, the cost could be different from your estimate. In some cases, a doctor will make an order in the middle of a procedure that can change the cost. Or, if you have a medical condition that’s being treated by several different doctors or if you are scheduled for multiple medical procedures in the same month, your initial estimate could be higher than your final bill.

How to Get Your Personalized Price Estimate

If you want to know the cost of your imaging exam before your appointment, call your center and ask for an insurance specialist to provide a personalized price estimate based on your coverage. Please have the following information available:

• Your referring doctor’s name
• The name of the procedure (example: Knee MRI with contrast)
• Your insurance card, coverage information or whether it is self-pay

Once we have that information, we can give you the cost over the phone and we can also email you a personalized price estimate. “We do this as a service to every patient to make sure that that component is taken care of and that they can deal with the issue that’s troubling them and they can get better,” says Alyssa. Ready to request your estimate? Just call your center and we can help.