Where should I go for an x-ray?

You need an x-ray ­– do you go for an x-ray at a hospital, urgent care, or a radiology practice? It’s a tough question. If you are like most people, your knee-jerk reaction would be to go to your local hospital’s radiology department. However, getting an x-ray done at the hospital could cost you more money than necessary. Here’s why.

How much do x-ray cost with insurance?

Insurance companies pay doctors and facilities through negotiated contract rates. The larger the organization, the greater their bargaining power and therefore, the higher their contracted rates for the services they provide.

If you need an x-ray or other radiological procedure, the costs for any given procedure will vary by facility. Typically, procedures will cost more at a hospital than at an independent radiology practice, and the contracted rates will be higher at the hospital as well. This distinction is important, particularly when a deductible comes into play.

Check x-ray costs with your insurer

If your health insurance has a deductible, you are responsible to pay the full amount of that deductible before your insurer pays anything. If you need an x-ray while you still have a remaining deductible to pay, in essence, you will be fully funding that x-ray yourself: the facility will bill your insurance company and the insurer will approve it at the contracted rate. The insurer will then apply the contracted rate for the procedure to your deductible, and you will receive a bill for that full contracted rate from the facility for that procedure. The higher the contracted rate, the more you are responsible to pay.

How much do x-ray cost at urgent care?

To ensure the lowest cost for the x-ray or radiology procedure, you need to do some research first. Ask the doctor who is ordering the procedure to provide you with the procedure code and the diagnosis code for the test.

Call your insurance company, tell them what you are having done and give them all the codes your doctor provided. Ask them to tell you what the cost would be at the hospital, urgent care, or an independent radiology practice (you will have to give them the name of specific locations in order for them to respond accurately). They will confirm the contracted rates at each facility and how much of that fee you will be responsible to pay, based on your plan and its deductible. You can then factor the financial piece into your decision about where to have the procedure done.

COVID-19 related x-rays

If you have been diagnosed with COVID-19, your doctor may refer you for a chest x-ray. However, many independent radiology facilities will not conduct procedures on people who have fevers or other COVID-19 related symptoms. This means that if you need a chest x-ray to confirm or rule out pneumonia, you will have no other choice than to have the x-ray performed at a hospital.

Having to get a COVID-19 related x-ray performed at a hospital can cause you to incur substantial expenses ­­– you may be required to enter through the emergency room which can result in additional costs for testing and evaluations. While most insurers are saying that they will cover all COVID-19 related illnesses without cost-sharing, it is still too early to know how these claims will be processed. Be sure to fully review any charges for these services with your insurance carrier to determine their accuracy and any responsibility for payment.

Contact a medical bill dispute advocate

If you have received an excessive or unexpected bill for an x-ray or radiology procedure, an experienced medical bill dispute advocate can help. Disputing a medial bill can be a complex process. Systemedic has been providing help with medical bills for over 30 years and knows what it takes to dispute even the most complicated medical bills quickly and effectively.

Offering a fee-based service for those looking to dispute their medical bills, Systemedic’s medical bill dispute advocates are skilled in navigating the insurance maze and will not take “no” for an answer.  To get started with resolving your medical bill dispute, contact us for a consultation.


 

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