Blue Cross NC has partnered with American Imaging Management, Inc. (AIM) for the management of outpatient, high-tech diagnostic imaging services. However, in the case of a high-risk pregnancy, it is best that you get the procedure done in a hospital where immediate medical help is available. Learn More . The total cost can add up quickly after including other charges by the surgical center, outpatient facility, or the hospital where you have the procedure done. We offer a complete choice of plans to meet your coverage needs and fit your budget. Coinsurance is a fixed percentage of the total costs you must pay out of pocket after reaching your deductible. Linked Apps. Why did Blue Cross NC implement a diagnostic imaging management program? Once you're registered, you can manage your account, choose to go paperless, review your benefits, see your claims status, view your digital ID card, and more - 24 hours a day, seven days a week. endstream We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Diagnostic Imaging. Prior approval is required by all facilities or settings that offer outpatient, nonemergency diagnostic imaging services. Additionally, the increased use of some high technology imaging procedures creates patient safety concerns from radiation exposure. Learn more about our non-discrimination policy and no-cost services available to you. If you want to save money on a renal ultrasound, it would be a good idea to call your nearest dialysis center and inquire about the cost. Register Now, Ancillary and Specialty Benefits for Employees. The Affordable Care Act (ACA) has identified certain services as preventive care to be paid at 100%. Please review the terms of use and privacy policies of the new site you will be visiting. Insurance barely negotiated down any of it. Use it at home at ibx.com or on the go with the IBX App! Data shows that roughly 30-40% of imaging exams are considered clinically inappropriate or noncontributory. Your deductible, coinsurance and copay all affect what you'll pay. Wellness and Other Special Features, 5(i). , CT scans, and more. 15 minutes. You may choose to go paperless and get your EOBs online by logging in at. Surgical and Anesthesia Services Provided by Physicians and Other Healthcare Professionals, 5(c). is a majority member of Compare.com. You can verify a member's eligibility and benefits in several ways. Clearly the message I'm getting from both the medical center and my insurance company is to just stay home and die next time I'm worried about a life-threatening condition. I was ordered US Abdomen Complete only but what they charged me besides the US Abdomen complete, they also charged me US Duplex which the doctor never ordered and they list it as other diagnostic services all together was over $2100. Important Information About Medicare Plans. Your premium is the monthly amount you pay to the insurance company. An abdominal ultrasound is used to view organs such as the gallbladder, kidneys and liver. If you do not receive your insurance though an employer, please enter the ZIP code for where you live. I never even saw a picture result of my gall bladder! I am insured (barely, through TRS, but that's another can of complaints), and the total cost would have been $1,407. ultrasound.) Insurance barely covered anything. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Search Express Scripts network for a retail pharmacy. I was told hospital Ultrasound would be a little over 700 out of pocket. You can also log in to your account, or register for one, on our website or using the mobile app to see your plans copays. Services, Drugs, and Supplies Provided Overseas, Non-FEHB Benefits Available to Plan Members. We're committed to supporting you in providing quality care and services to the members in our network. 3 You must be the contract holder or spouse, 18 or older, on a Standard or Basic Option Plan to earn incentive rewards. You must obtain prior approval for BRCA testing (see page, Participating laboratories or radiologists: 30% of the Plan allowance (deductible applies), Non-participating laboratories or radiologists: 30% of the Plan allowance, plus any difference between our allowance and the billed amount (deductible applies), 5(a). Sometimes privately owned clinics offer discounts and promotions, especially on 3D and 4D ultrasounds. Box 954722 St. Louis, MO 63195-4772. and less than $2800 deductible for a family is a low deductible plan. Usage Agreement I was given a script for an ultrasound of my abdomen by my primary physician due to abdominal bloating. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. They told me it would be $1,793! 2021 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus, Laboratory tests (such as blood tests and urinalysis), X-rays (including set-up of portable X-ray equipment). . Went in because doctor wanted to check for premenopausal signs. They include: Your Schedule of Benefits (SOB) includes information about what services are covered, what's not covered and how much it will cost. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. Before making a final decision, please read the Plan's Federal brochures (Standard Option and Basic Option . It can be used to investigate abdominal pain or swelling and to diagnose gallstones, kidney stones or cancer. Emergency Care. Coinsurance is a fixed percentage of the total costs. . Are you planning a Labor Day picnic? I would have gladly driven to Lexington myself if I had known how much I'd save! Paying for health care Simply enter the type of ultrasound procedure and your zip code to start comparing healthcare providers in your area. Ambulatory surgical centers are stand-alone facilities where you can walk in, go through a diagnostic or surgical procedure, and go home the same day. Greater New Orleans/Northshore: Over the last 20 years, the United States has made great strides in expanding access to care, with 92% of Americans now covered by health insurance a historic high. Pick a directory to search or find other helpful information about drug resources, quality programs and more. When submitted, the claim will be processed in accordance with the terms of a subscriber's health benefit plan. During the Public Health Emergency (PHE), over-the-counter (OTC) COVID-19 . How does Blue Cross NC ensure that the program does not negatively impact patient care, divert physicians from the practice of medicine or compromise the patient/physician relationship? Only ordering physicians can obtain a prior plan approval number. Learn more about our non-discrimination policy and no-cost services available to you. Benefits are available for specialized diagnostic genetic testing when it is medically necessary to diagnose and/or manage a patients existing medical condition. If not, the MIBlue Virtual Assistant can help you find the plan information youve been searching for. You've got health insurance. For example, if your deductible is $900, you will have to pay up to $900 out of pocket for your medical treatment before your insurance pla. %PDF-1.5 % Data driven insights, stories of inspired healthcare solutions and the interactive BCBS Health Index. Dn3u. You can go to your nearest Planned Parenthood to get a. . Coinsurance is your share of the costs of a health care service. This website does not display all Qualified Health Plans available through Get Covered NJ.To see all available Qualified Health Plan options, go to the New Jersey Health Insurance Marketplace at Get Covered NJ.. Products and services are provided by Horizon Blue . You can also visit. Your member ID card is your key to using your medical plan benefits. Before insurance, cost was $4,720. Some preventive services are covered 100 percent by your insurance, which means there's no cost to you. Espaol | Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. The transducer emits sound waves to create a picture of the abdominal organs, such as the liver, gallbladder, spleen, pancreas, and kidneys, on a screen. This type of plan might be suitable for you if you only prefer to visit particular healthcare providers and do not plan on using anyone elses services except in case of emergencies. Based on clinical criteria, AIM will issue a prior approval number or will forward requests to a nurse or physician if they require further review. And no definite Dx as of yet because Covid19 took over 3 days later so my primary doctor hasnt even called me. As of December 31st, this portal will no longer be active. The amount of the . <>stream He graduated with Latin honors from Virginia Commonwealth University, where he earned his Bachelor's Degree in Digital Journalism. They are mostly located in the vicinity of the hospital that owns them. This was my out of pocket expense. endobj The program will apply to members covered by the following plans: Blue Options SM (group PPO plan), Blue Option HRA (group PPO plan), Blue Options HSA (group and individual PPO plan), Classic Blue (Group CMM plan), Dental Blue (group and individual dental plan), Blue Advantage (individual PPO), Short Term Health Care (individual CMM plan). We were unable to automatically detect your location, but you can choose your state manually to see content that is most relevant to you. Received two bills: one in later April 2018 from San Antonio Radiological Medical Group with billing code 76700 Charges $159, Patient Balance $42, which looks reasonable. Eligibility and benefits The benefits of each plan vary widely by contract. A PPO might be suitable for you if you only prefer to visit particular healthcare providers in your area but want the cushion to visit out-of-network providers as well. 66 0 obj endobj The Diagnostic Imaging Management Advisory Group is asked to help develop future phases of the diagnostic imaging program, including addressing over-utilization by self-referring physicians as necessary. endobj As shown below, healthcare services are put in seven simple benefit levels with copayments for in-network services. Each member of a Basic Option plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums. , Non-FEHB benefits available to you after reaching your deductible called me was given a for... In providing quality care and services to the insurance company only ordering Physicians can obtain a prior plan number! My primary doctor hasnt even called me with the terms of use and policies. 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