Selling Copayment Vs Percentage for Advanced Imaging

Nov 28, 2016

  1. wehotex
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    wehotex Guru

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    The local Humana Medicare PPO features a $255-325 range for radiology services such as CT, MRI, etc. Of course, the other competitors (AETNA PPO & Care Improvement) are smart enough to feature a 20% coinsurance and look alike on paper. The prospect asked me about the charge for CT scans. When I visited a local imaging center, I got nowhere by asking questions to the Billing Dept since there are so many possibilities. So, I don't know which charge is the lesser? I'd like to think that the HUMANA copayment works out to be cheaper, but I have my doubts. Anybody have any experience with this?
     
    wehotex, Nov 28, 2016
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  2. agentjhc
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    Recently someone posted a link for typical medical costs (Somarco or Sman?).
     
    agentjhc, Nov 28, 2016
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  3. goillini52
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    goillini52 MAGA...BUILD THAT WALL!!!

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    I had a Cat Scan in May and it was $2,680. Looks like Humana's the better deal on that procedure.
     
  4. wehotex
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    wehotex Guru

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    Yikes, with insurance?
     
    wehotex, Nov 29, 2016
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  5. goillini52
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    goillini52 MAGA...BUILD THAT WALL!!!

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    Yes.................when they got done, I asked them what year it was. Felt like I was in a time machine.
     
  6. vic120
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    vic120, Nov 29, 2016
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  7. FLM2
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    It sounds like it was done at a hospital outpatient facility rather than Imaging Center, the cost difference is substantial
     
    FLM2, Nov 29, 2016
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  8. goillini52
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    goillini52 MAGA...BUILD THAT WALL!!!

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    Yes it was.................
     
  9. ICACharleston
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    I make it clear that the percentages are based on the Medicare approved amount. I illustrate this to prospects with an old EOB for a scan my wife had some time ago. The billed amount was $656 or so, Medicare approved $150 and she paid thirty bucks. So what she actually paid was 20% of twenty percent. We all know these fees and medicare approved amounts aren't linear or consistent but people feel comfortable.
    I have plans with flat rates as well as percentages but the illustration relieves people.
     
  10. yogooglethis
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    yogooglethis Guru

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    In North Fl. complex imaging such as MRI,CT at the 20% co insurance of ma plans are around 50.00 -75.00 at freestanding imaging centers and about double that at a hospital imaging center
     
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