Health Insurance Providers Tightening Restrictions on MRI Scans
Anthem Health Insurance will no longer pay for outpatient MRI and CT scans for it’s insured.
Modern Healthcare reports that Anthem is taking a stand against high hospital prices to encourage patients to use private imaging centers instead. Hospitals charge more for an MRI procedure than private imaging centers.
MRI machines mean more business for medical providers. Since each machine cost millions of dollars to purchase and service, they are able to charge a fee each tome someone uses the MRI scanner. If they need contrast dye or anesthesia the price goes up even more. In some cases facilities without their own imaging centers will refer patients to a health organization that offers this service for an additional source of income. And the average price of an MRI fluctuates widely depending on what state or country you get it.
Anthem is worried about hospitals taking advantage of this situation to charge insurers for unnecessary spending. But from the doctors’ point of view it might affect their ability to deliver healthcare to patients in need.
Under the new program, doctors have to send an authorization request to Anthem, who then reviews it to determine if an MRI procedure or a CAT scan is a medical necessity. If they determine that a scan is not needed to stay alive, then the physician has to refer them to an online portal of private imaging centers.
According to Radiology Business, the American College of Radiology “vehemently opposes” Anthem’s new MRI policy. Radiologists around the country have complained it will dramatically affect their ability to provide quality patient care. The Lung Cancer Alliance also spoke out against Anthem Health Insurance’s new policy.
One way to decrease imaging costs is to buy refurbished parts from a company like Sound Imaging. They also provide part repair and refurbishing services, which can save a lot of money on servicing.