About Amy Umble:
Amy Umble is health reporter for The Free Lance-Star
My road-to-Damascus moment came when the bill for the MRI arrived
I’ve always known that you can save money if you shop around for your health care. But that knowledge was abstract, something that I read about rather than experienced. Yesterday it became personal.
My road-to-Damascus conversion began in January when I went to Medical Imaging of Fredericksburg for an MRI. Medical Imaging billed my health insurance company, UnitedHealthcare, $1,976 for the test. But United has a contract with Medical Imaging and paid the contract price, $1,778.
Our health plan requires employees to pay a portion of the cost of imaging and lab work. So United paid 80 percent of the eligible expenses, and I paid 20 percent. This worked out to $1,423 for United and $356 for me.
Then I realized, if I’m going to pay 20 percent of the cost of these expensive tests, maybe I should shop around. If I shopped around, could I get a competent test for less? The answer was yes.
I learned this when I called UnitedHealthcare and talked to one of their representatives. The representative said that United also has contracts for MRI testing in the Fredericksburg area with Pratt Medical Center and the Spotsylvania Regional Medical Center. United will pay Pratt $846 for the same MRI. At Spotsylvania Regional, the contract price is $988.
In other words, the cost at both places was considerably less than the cost at Medical Imaging. And my share, of course, would have been a lot less. I would have saved $187 if I had gone to Pratt and $158 if I had gone to Spotsylvania Regional.
Yikes. I paid almost double what I would have paid had I been a better informed consumer. People with high-deductible insurance policies have probably figured out long ago that you can shop around and pay less when you need work done.
The UnitedHealthcare representative said she did just that when she needed surgery for a torn ACL. She called three hospitals in her area, searching for quality at the lowest cost. She added, “I was able to do that.”
Now, I’m one of these careful shoppers. Get a procedure code beforehand from the provider, the United representative said, and the company can provide cost estimates. (She added that this works for facilities, but not for doctors.) So now I’m wondering about any lab work that I’ll need. LabCorp or Quest? I wonder which is cheaper.
UPDATE: This afternoon I feel like the Emily Litella character that Gilda Radner did on the Weekend Update section of “Saturday Night Live.” Emily would pontificate about an issue until the Weekend anchor would point out that she had misheard something or misunderstood it. At that point, she would turn to the camera and with a sheepish look say, “Never mind.”
I thought of Emily after receiving a call this afternoon from Ed Swager, the CEO at Radiologic Associates of Fredericksburg, a sister company of Medical Imaging. He pointed out the same thing that commenter John LaVoy did on Facebook, that there may be a key difference between the bill I received from Medical Imaging and the ones I would receive for similar imaging services at Pratt Medical Center or the Spotsylvania Regional Medical Center.
Patients receive one bill from Medical Imaging, which includes the charge from the radiologist to read the image and the charge from the facility to take the image. I called Pratt and Spotsylvania Regional this afternoon, and they confirmed that patients there receive two bills, one from the facility and one from radiologist.
So the comparisons above are not useful without those bills from the radiologists. And a UnitedHealthcare representative said this afternoon that they do not have those numbers to give to their customers.
My apologies to the folks at Medical Imaging. Comparison shopping for medical services can be a good thing, though the comparisons have to be valid ones.
(You can follow Rapid Assessment on Facebook. Just go here to the Fredericksburg Health page and like it.)