off topic - is the compassionate care pricing lower then insurance contracted rates?

Sorry for an off topic question - but I had my CT scan and bone scans done recently and now the doc wants to do MRI, because the bone scan found something on the femur bone.

My annual "max allowed for diagnostics" services was reached within the first 5 days of the calendar year :). So the Hospital Called me and they told me that for the MRI, I will have to pay at the time of the service.

I asked that "I want to make sure you will not charge me more then the insurance company contracted rate", i.e. i still have the insurance - and he suggested that the rate he is offering to me is a "compassionate care rate", which is "lower then the insurance contracted rate" - so they will not be submitting the claim to the insurance company.

Does this sound correct? Or should I be asking them to submit the claim to the insurance company and pay whatever is the contracted rate?

What they charge is really a very low priority compared to making sure that this Femur bone spot is -ve. But I want to make sure that I am not overpaying for the services.

Thank
Ein

142 said...
I would ask the insurance company what the agreed rate is. Mine has a web site where they give you the range of cost, expected co-pays, and the like.


They should provide you with that information - informed patient and the like -

Thanks 142 - I had tried to do that at the time of bone scan and CT scan, but the insurance company wanted to know the exact code / exact procedure names etc - "we can't tell you the rate until we are billed by the provider".

Ask the hospital what the procedure code is - they should be able to tell you that. There may be more than one code - the test, supplies, and reading the results may each be a separate code.

These days, its all about the exact code, so to make it apples to apples, for the use you need, you would need the precise code in order to assertain the pricing and cost to you.

david