You Want How Much!

Medical providers can charge whatever they want. Heretofore no one cared. Until now…..

A San Antonio employer left the managed care world last year and embarked upon a different health care reimbursement strategy: Reference Based Pricing.

Most providers have been found to accept members under the plan. A few, however, have not. One is a radiology clinic that has demanded 200% of Medicare. The group plan pays 120%.

So the employer advised their employees to seek radiology services elsewhere. Below is a redacted Notice to Employees sent out by the group a few days ago:

There have been instances where XYZ IMAGING CENTER has refused to submit claims on behalf of our insureds. XYZ has requested payment in advance before providing service. We encourage you to consider alternatives to XYZ to avoid the billing inconvenience and/or balance bill.

The following radiology and imaging centers located throughout San Antonio accept our plans as payment in full for services rendered and are offered as alternatives to XYZ:

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As in all purchases, it pays to shop around, even in health care.

In the meantime other employers in the area accessing managed care contracts are paying 200%+ of Medicare at XYZ IMAGING. And their health insurance rates reflect it.

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