Switch on the evening news on just about any given day and you will see a story about how Americans? wages have stagnated, even in the face of declining unemployment figures and stable inflation. Social Security recipients will not be getting an increase in 2016, but you can bet there is one thing that will be going up:
The amount you will pay for healthcare.
Whether it is in the form of higher premium costs, higher deductibles and co-insurance or the cost of the visit, test, procedure or hospitalization itself it will cost more.
It seems sometimes there is very little one can do personally to combat these increases. But Teresa Cole, financial manager at Lexington Outpatient Diagnostic Center and Open MRI, has some ideas on how you can take steps right now to control your healthcare costs. With 20 years of experience in healthcare billing, she is someone to listen to.
#1. Get Testing, Procedures Done Now
If your physician ordered tests or procedures for you earlier this year and you have been putting it off, now may be the perfect time to move forward. ?By this time of year, most people have met their deductible and some have achieved their out-of-pocket cap,? Cole said. ?For people in this situation, the amount they?re responsible for could be nothing, or close to it.?
If you have just completed Open Enrollment at your employer, then you should have an idea about changes to your plan for 2016. Changing what?s covered, at what level, is one way employers and insurance companies are working to rein in costs. You may pay more for a CT scan in January than you would now simply because of insurance changes.
Hospitals often update their fee schedule ? called a charge master ? around the first of the year, too.
#2. Shop Around
Patients have the right to have outpatient testing and procedures done wherever they like.? Often, they just ?go with the flow? and have it done at the hospital where their doctor is. That decision can end up costing hundreds, even thousands of dollars, Cole said.
?Obviously there is a difference between an organization like Lexington Diagnostic ? where the only thing we do is imaging ? and a hospital,? Cole said. Hospitals carry a lot of overhead ? inpatient beds, surgical suites, emergency rooms and so on. ?They need to have a higher fee schedule to cover their costs.? Cole said. Lexington Diagnostic does not have those expenses to pass along to its patients.
For example, Cole shared the story of a family member who recently had a chest x-ray at one of the local hospitals. ?The bill was $600 just for the hospital part. That did not include the radiologist?s fee for reading the exam,? she said. ?The same test at Lexington Diagnostic Center would have cost $50. Total.?
#3. If You Have an FSA, Use It Up
?Flexible Spending Accounts are a great way to plan for and pay your healthcare costs,? she said, ?but only if you use all of the money you put into the FSA. If you don?t use the funds you set aside, they don?t roll over.?
Every FSA is different, but in general you will need to have your testing or procedure performed by Dec. 31, 2015, to use the FSA funds from 2015. Some plans provide a grace period, but be sure to ask. ?Know the rules so you can take advantage of the money you?ve set aside,? Cole said.
Another point of confusion with FSAs is around service and billing dates. ?A lot of people think that the time the bill is processed or received is what matters when it comes to using the FSA funds,? Cole said. The only dates that are important are the date of service and the deadline for submitting claims, she noted.
#4. Ask About Discounts ?
At Lexington Diagnostic Center and Open MRI, self-pay patients receive a substantial discount off the Center?s already low costs. ?When you compare what we charge to what others charge, and then apply the discount, you really begin to see a significant savings,? Cole noted.
Another option is to ask about payment arrangements. ?It doesn?t hurt to ask and if there is a way to make it work, we certainly will try,? Cole said. Lexington Diagnostic also accepts major credit cards, such as Visa, MasterCard, American Express and Discover. From time to time, those companies have no-interest promotions that could really help.
#5. Understand Your Insurance Benefits
Many people do not know or understand their health insurance benefits, Cole said, which can lead to some really big ? and unpleasant ? surprises. ?People need to take control of their benefits and understand what?s covered, what?s not, and what they are responsible for.?
?A huge misconception is that if they have insurance, it?s going to pay for everything,? Cole said. ?In most cases it is not.? Patients at Lexington Diagnostic Center always know what they are going to have to pay ? upfront ? without any uncertainty or doubt.
?Our financial team is here to help patients. We collect their insurance information up front, contact the insurer to determine what their benefit is, and then let the patient know how much they are going to be responsible for.? There are no surprises, no mystery bills three months later. It gives patients peace of mind and the ability to really budget.
Lexington Diagnostic Center is an ?in network? provider for nearly all of the major insurance plans serving the Lexington area, including:
??? ?Anthem
??? ?Humana
??? ?Bluegrass Family Health
??? ?Traditional Medicare
??? ?United Health Care
??? ?Cigna
??? ?All Kentucky Medicaid managed care plans
??? ?Worker?s Compensation
In addition, Cole said, Lexington Diagnostic accepts insurance claims associated with motor vehicle accidents.
Finally, Cole said, it is important to understand that hospitals are not the only places you can receive high-quality, state-of-the-art care. Lexington Diagnostic Center and Open MRI provides the most advanced imaging services available, in a comfortable, convenient location. Studies are read by board- certified, fellowship-trained radiologists who live, work and are active participants in the Lexington community. They care about their patients, their city, and its residents.
Wishing you a happy and healthy Holiday Season from Lexington Diagnostic Center & Open MRI