To update on the Cost Comparison of brain MRI.
I called my patient and explained the quoted costs on Friday. She preferred to have the procedure in Poulsbo rather than at our local hospital.
On Friday my receptionist scheduled the procedure in Poulsbo, done yesterday.
On Friday I called my local hospital and cancelled the MRI scheduled with them.
Today I spent much of the day on the phone trying to check costs for a CT scan of the abdomen and pelvis with and without contrast for a different patient. First checking with different facilities for their prices. Then asking the insurance what the contracted amount is for that facility. That is the allowed amount that that particular insurance has contracted with that particular facility. I am sure that it is less than or equal to the amount billed, but that's all I'm sure of. The Washington State Office of the Insurance Commissioner* says that the patient should be able to get that information from the insurance. The insurance says that only the provider's office that is going to do the procedure can request that information, because it's proprietary contract information**. The third call to insurance today was 45 minutes and 37 seconds long.
Transparency, anyone? Want to shop around for costs? I hope to detail today's calls soon.
*Washington State Office of the Insurance Commissioner is at http://www.insurance.wa.gov/
**Proprietary contract information. In this case that means that the doctor/facility has a contract with the insurance. So this is an "in network" doctor/facility. The contract spells out how much the insurance has agreed to pay the doctor/facility for any procedure. The contracts can be different with each insurance and each doctor/facility. This is the "allowed" amount that shows up on the explanation of benefits from the insurance to the patient, which is different from the billed amount.