I love alternative medical practices where providers compete for patients’ business on price, quality, convenience, and other amenities. All too often I am disappointed. Trying to force competition onto a rigid health care system is like trying to pound a square peg through a round hole. What usually happens is that firms initially start out trying to attract cash-paying patients but later pivot the business models catering to health plans.
The Affordable Care Act resulted in more people with health insurance, especially bad health insurance. Under Obamacare’s sky-high deductibles a few firms are trying to help under-insured (and uninsured) patients get a better deal. A family member was advised by her doctor to get an ultrasound. She has health insurance, but like many Americans, the entire bill would be out of pocket due to cost-sharing. Prices vary and it is difficult to get an estimate. She decided it would be easier to just pay cash if she could find a cash deal. She asked me for help knowing I have written about health consumerism.
A firm called Radiology Assist offers competitive prices for numerous services at diagnostic imaging centers around the country. The prices I found for an ultrasound in North Texas varied from $97.50 to $388.65 depending on the location. One concern was how to ensure the $147.22 price quoted on the website for her preferred location is the actual price? It sounds simple but each radiology clinic has numerous prices for different customers for the same procedure. She called and talked to a customer service representative, who explained the process. Her questions were likely already answered in the website FAQ section, but she wanted reassurance before filling out an online reservation form. After the patient submits an online form, and they receive a physician order, Radiology Assist collects the payment and makes the reservation. Prices can vary slightly from the estimate due to the precise CPT codes the doctor uses.
The process was not entirely smooth. My family member’s doctor called the phone number and left voice mail requesting a referral form. Downloadable forms are on Radiology Assist’s website, but the doctor’s office was not willing to dig through a website looking for a form. A few days later the doctor complained she still had not received a referral form. In addition, Radiology Assist said it still had not received the referral. Another phone call to customer service explained where to find the physician order forms and the link to the form was sent to the doctor. Perhaps that needs to be an option on the customer service phone line, “if you’re calling from a provider’s office, referral forms can be found at www.radiologyassist.com/referral-center/” The problem is that doctors’ offices have rigid ways of doing things. The doctor left voice mail and expected a call back or a form faxed to her. That may sound antiquated, and it is. The only offices in the United States who still use fax machines are medical offices and the U.S. government.
Finally, the order form was faxed, the reservation scheduled, and a notification was sent to my family member. Here is where it gets interesting. Radiology Assist emailed an identification card asserting the patient is insured through Assist Health, with no deductible and no cost sharing. Patients are advised never to reveal any other insurance plans, or the process may turn into problems Radiology Assist cannot fix. I wonder if that means some diagnostic imaging centers will latch onto the best paying insurance available. Or perhaps a diagnostic center just gets confused how the process is supposed to work. Another reason for this method is that it is generally illegal to pay referral fees (i.e., kickbacks). That is, Radiology Assist cannot just say, we are sending you a patient and we expect our cut. Rather, the firm acts as the insurer, pays for the diagnostic service while charging their patients a slightly higher price.
Despite the initial hiccups the process went smoothy once the reservation was scheduled. The prices are good. MRIs start out at $265, CT scans at $130 and mammograms at $140. The company also has several other business lines including colonoscopies.
Patients benefit when they have options to avoid inflated medical prices. Most patients do not realize prices vary. With Radiology Assist, they can view price estimates for different locations and decide where they want to go.
1 thought on “How to Buy Diagnostic Imaging at a Huge Discount”