Patient Advocate News: Anthem to Stop Covering Outpatient Imaging Care

by | Sep 8, 2017 | 0 comments

Due to rising healthcare costs, more and more insurers are having to take drastic measures to keep premiums low and maintain their profit margins. Anthem has recently announced that it will no longer pay for MRIs and CT scans performed on an outpatient basis in hospitals across the country. As Modern Healthcare reports, Anthem’s new policy is indicative of the future, even though such measures may only worsen patients’ access to care. The article warns that insurers’ attempts to push patients to lower-cost options, like stand-alone imaging centers, will lead to fragmented care and disrupt the doctor-patient relationship. In the attempt to save money, patients may be left with few options to receive the vital care they need.

Anthem’s refusal to pay for hospital imaging services also adds to the already bureaucratic processes that healthcare providers must navigate, further reducing their limited time to care for patients. ”A physician’s time is being taken away from patient care and refocused on claims adjudication, and that’s not good for our healthcare system,” warns Brian Tabor, president of the Indiana Hospital Association. (You can read the whole story of Anthem’s recent policy changes and their effect on patient care here.)

So what does this mean for you, as a patient who may one day need vital care that is not covered by your insurance? One of the best ways you can protect yourself is by staying informed and making a plan. Contact your insurance provider to get a specific list of what services and which healthcare providers they will and will not cover. Stay up-to-date with your insurance provider by signing up for their newsletters, and pay attention when they send you notices of plan and policy changes. If you know you will be needing costly services, call a patient advocate center before receiving the care.

If you find yourself needing, or have already received, care that your insurance provider will not cover, look for a patient advocate. Check to see if your local hospital has patient advocate services that may be able to help you, or contact Values Based Patient Advocates for advice. We can help you figure out the best options for your situation and area. We know that with rising costs, the healthcare field is getting harder and harder to navigate as both insurance companies and healthcare providers change their policies. Regardless of new challenges that may arise, we are here to advocate for you and to help you get the best possible quality of care!

Our Patient Advocate Office is ever just an email or phone call away: 703-222-1300 – we’re happy to help! A phone call is free and it could save a life or reduce a large hospital bill.

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