Imaging Price Transparency Reaches a New Level in the Sunshine State

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Lord_1329925299.jpg - Imaging Prices - Don't use until 3/1/12

“I’ll have a turkey and cheese on rye, MRI on the side, please?”

It might seem like a stretch, but it looks like the way you order your sandwich at the local deli is the same way the state of Florida is hoping for patients to acquire healthcare services. With upwards of 50 million uninsured Americans, the healthcare community has seen a significant spike in price-shopping trends. The state of Florida’s proposed legislation that would require physicians to post signs in their waiting rooms, showing their cash-pay pricing, seems to be a flawed attempt at empowerment in this price-sensitive patient market.

The response to this proposed rule is decidedly negative from most physicians, as it seems that the legislation is attempting to compare hoagies and paninis to medicine. Our facility, Advanced Imaging Centers, has taken a different approach. We recognized a need in the patient population as well as our referring physician supporters for a simplified cash-pay pricing structure before this legislation was announced, which led us to implement our new initiative and post and publicize cash-pay prices. Radiology is the most price-shopped medical procedure, and we want our patients to take advantage of pricing transparency and be empowered to make decisions balancing price, service and quality.

Patients are becoming more aware of the need to serve as their own healthcare advocates, leading them to search for options. We have invested in this process by advertising the true cash-pay prices at our facility and by subscribing to Save On Medical ( SaveOnMedical.com), which allows patients to search for services in their region and compare local facilities based on price and quality scoring.

The new process compiles all types of exams and allots one flat fee for each modality, which encompasses both the technical and professional portions of the exam. An MRI, for example, would have one flat cash-pay price regardless of whether it was ordered for a patient’s neck or back, with contrast or without.

Our staff understands that to survive as an independent facility, we must use service and patient care as differentiators. If patients are looking for pricing transparency, we are going to provide it. By showing patients what we are actually charging them, the payment process will be more seamless, leading to improved collections.

Unfortunately, if passed, the law will require offices to post their fee schedule, which is the highest amount a patient could pay. A radiology facility’s fee schedule is comparable to a suggested retail price in business. The cash-pay price is typically less than the fee schedule. However, in healthcare, insurance companies and government agencies develop their own contracted rates as a percentage of the practice’s fee schedule.

A patient considering the price for an MRI would have a difficult time understanding how he or she would be charged without having the knowledge of a medical billing professional. The patient hears, “We’re charging $500 for this exam, because we have to send a fraction of it here and a fraction of it there and then split it in half again.” Transparency requires a patient to understand the fee schedule, which means that the rule could end up being more of an inconvenience for practices without benefitting the patient population, and we are aiming to please our customer—the patient.

We want our patients to understand that they have choices when it comes to their care, so that when they choose us, they have confidence in our quality of service and in the amount they will pay, in the same way they have confidence in their go-to favorite sandwich.

Jayson A. Lord, MD, is one of the three on-site board-certified radiologists who own Advanced Imaging Centers in central Florida.