Helpful Answers to the Frequently Asked Questions We Receive
A HSA is a savings account that you can use to pay for qualified medical expenses. Some medical insurance companies offer HSA plans as part of the benefits within a high deductible insurance plan. A major advantage of contributing to an HSA is that the amount you contribute is considered a pre-tax amount (annual limits apply) and thus you reduce your annual income taxes by contributing to your HSA. You don’t have to spend the funds in your HSA in a specific year - unspent funds are allowed to rollover to the next year and you can spend them in the next year. HSA funds also remain available to you even if your medical insurance company or your employment changes.
Yes, we take insurance! We also offer the option of affordable self-pay pricing. Our patients take advantage of our self-pay pricing for a variety of reasons:
- When they don't have insurance
- When they have insurance with a high deductible but they don't think they will meet their full deductible in the current year
- When they have insurance but don't want to use their insurance for a specific service
As part of your medical insurance, a deductible is the amount of money you have to pay each year before your insurance company will pay for medical expenses. Most deductibles usually restart every year at the beginning of the calendar year or your insurance company’s fiscal year. For example: If you have a $2000 annual deductible, you have to pay the first $2000 of your medical expenses for the year. Once you have paid $2000, you have met your deductible. After you have met your deductible, your insurance company will pay a portion of your medical expenses that year, and you also will pay a portion of your medical expenses.
With your medical insurance, a copay is a fixed amount that you need to pay for specific radiology services. Copays are usually paid by you at the time you receive the service. The services which require a copay will vary with each medical insurance plan. For example: you visit our office for a CT scan, and your insurance plan requires you to pay $25 for the office visit.
Coinsurance is the number of medical costs you have to pay after your insurance pays its portion of your bill. Coinsurance usually begins after you have met your annual deductible and is usually a percentage of your bill. For example, you have paid for other medical costs during the year and have already reached your deductible. Now you need to have an MRI that costs $1000. If your coinsurance is 25%, your amount to pay for the MRI will be $250.
In a medical insurance plan, an In-Network provider, which may also be known as a preferred provider depending on your insurance company, are the clinics, doctors, and providers that agree to pay a fixed rate of medical costs for members of their insurance plan. Think of In-Network providers as the clinics, doctors, and providers that have reached an agreement with your insurance company to help pay for services needed by members of your plan. An Out-Of-Network provider is a clinic, doctor, or provider that is not part of the list of preferred providers in your medical insurance plan, and the amount of coverage that your insurance company will pay for their services is usually less than the amount of coverage you receive for a preferred provider.
Within your medical insurance plan, your insurance company and the provider have agreed on how much the insurance company will pay for a medical service - this is known as the allowable charge. The billed charge is the amount that a provider normally charges for a specific medical service, and is often higher than the allowable charge. Your bill is considered paid in full when the allowable charge is paid and any required copay or coinsurance amounts have also been paid.
For certain radiology services, depending on your medical insurance plan, your insurance company may require that you receive approval or pre-authorization from them before you visit our office and receive the service. If you don’t obtain their approval before you receive the service, your insurance company may deny payment for the service. To make sure you’re covered for a specific service, it’s best to contact your insurance company before your office visit.
We normally recommended that you have a doctor’s order or referral to receive medical imaging. In this age of instant information it might be tempting to want a MRI without consulting your doctor, but when Dr. Evans coordinates with your doctor this assures that you receive the best possible care and optimal treatment plan. Your doctor has the history about your health, which helps Dr. Evans understand your radiology results more accurately. Our report is then shared with your doctor who is best qualified to create your treatment plan - this collaboration is smart health care in action.
Note that you do not need an order or referral for a screening mammogram, or for any medical imaging or procedure for which you pay in full at the time of service.
Radiologists are full medical doctors who have a background in diagnosing diseases and injuries with the use of medical imaging procedures such as MRI, CT, X-ray, and Ultrasound. Our Radiologists don’t replace your doctor or specialist - rather they work in coordination with your doctor or specialist and provide a radiology report to your doctor or specialist that they can use to more accurately treat and serve you.
