Selling Copayment Vs Percentage for Advanced Imaging

[wehotex]

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

That's ALL!!!?? They must give them out like candy there?

 

[Ron Van D]

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

I have the picture to prove it!

 

[goillini52]

I have the picture to prove it!

................................

 

[wehotex]

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.

You may be on to something. The prospect told me that she paid $30 for a CT scan using her Medicare card. I feel Dead in the water before I even was about to go talk to her again. Not worth it.

 

[vic120]

I believe I have changed my opinion on copay vrs %, I have always leaned copay, But I now see % is not as bad as it seemed

 

[wehotex]

I believe I have changed my opinion on copay vrs %, I have always leaned copay, But I now see % is not as bad as it seemed

I'm going to try to locate some current customers to ask them what they pay for these services. In my market, one of the local MAPDs offers Complex Radiology for $50-100, but I consider that to be reasonable. Humana PPO's $255-325 seems excessive and an uphill struggle to sell when the prospect already has history of what she has paid with Medicare (like this one). I just have to let this one go, unless she's willing to pay for a Med Supp and if she passes UW?

 

[vic120]

I'm going to try to locate some current customers to ask them what they pay for these services. In my market, one of the local MAPDs offers Complex Radiology for $50-100, but I consider that to be reasonable. Humana PPO's $255-325 seems excessive and an uphill struggle to sell when the prospect already has history of what she has paid with Medicare (like this one). I just have to let this one go, unless she's willing to pay for a Med Supp and if she passes UW?

That Care Improvement plus has been a good plan this AEP, PPO with same copay out of network, Its been fairly easy sell, I have had some push back on the % for services, But I now I feel more confidant about that and believe its even stronger

I only sell Humana when I absolutely have too I hate dealing with them,

 

[Chazm]

Here in north FL I've seen 20% MRI as around 200-$250

 

[ICACharleston]

We only get feedback on claims when there's a problem so I think the 20% for outpatient surgery must be working out pretty well for the clients, since I am not getting complaints. That's the same as Original Medicare would cost them but the MA plans have a cap. I've followed up on clients after OP surgery and they don't recall what their 20% was, so I guess it's not a sore point.

 

[yogooglethis]

Here in north FL I've seen 20% MRI as around 200-$250

200-250 ? where at
the richy rich trump tower wing at the mayo clinic? 20% for mri on original medicare is usually around 100 at free standing imaging centers from the eob i have looked at