Imaging guide

Key takeaways

• Where you receive imaging services greatly impacts cost. Medical imaging is a standardized commodity – meaning, you will receive comparable results regardless of which facility you go to.
• You can choose where your imaging is done – don’t rely on your provider’s imaging preferences.
• Sidecar Health members can use RadiologyAssist* to unlock all-inclusive, flat-rate prices with imaging providers available nationally and get access to a dedicated RadiologyAssist patient navigator to help schedule appointments. Learn how Sidecar Health members can use this service.
  • Note: While RadiologyAssist offers competitive rates, it's important to note they may not always be the absolute lowest. Comparing prices between RadiologyAssist and other imaging centers directly can still lead to additional savings.

Shopping for imaging is a great way to save

Sidecar Health benefits can be used at any facility that accepts VISA or cash payment.

  Pro-tips

Where you receive imaging services greatly impacts cost.

• Do not get imaging without shopping around. Except in urgent or emergency situations, take advantage of your options to find the best pricing.
• Call imaging centers near you (a simple Google search will do the trick!) and inquire about their pricing for the specific test(s) you need. This proactive approach can help you find the most affordable option.

 We've included some sample scripts below to help you feel comfortable calling and asking for pricing. Use them as a guide, or feel free to adapt them to your specific situation.

  Checklist

Follow this simple check list and you’re good to go. 

• Ask your provider for the requisition form so you can shop (script below).
• Know your “Benefit Amount” before you schedule imaging by utilizing the care search tab.
• Call your imaging center ahead of your visit. Verify the procedure code(s) and cost for your imaging service(s). You can also use the Sidecar Health member portal, to find a provider near you. We recommend calling a few places to compare prices.
• Medical imaging bills typically have two components: technical and professional. When you call to ask for the price, ask for the CPT or procedure codes for both.
  • Technical component: equipment and supplies and related costs.
  • Professional component: interpretation of the images by a medical professional.
• Get your itemized medical invoice and upload an image of the invoice to the member portal under the “Expense” tab within 90 days of the service date.
• If you got your imaging at an outside facility, be sure to forward the results to your provider.

Breaking down your imaging benefits

• Preventive care imaging (i.e. screening) will skip the deductible (if applicable). You will only be responsible for any amount above the Benefit Amount.
• Diagnostic imaging (i.e. imaging to diagnose an issue) will not skip the deductible (if applicable). You will be responsible for meeting your deductible, plus any amount over the Benefit Amount.
• You do not need to shop for imaging in emergencies. For imaging that is part of emergency care, you will only be responsible for covered charges up to your deductible/MOOP (Maximum-out-of-Pocket)

  Sample scripts

TALKING TO YOUR PROVIDER ABOUT IMAGING

"My insurance works differently, they pay fixed Benefit Amounts for each service and I have the ability to shop for imaging. I will have to pay the difference when the imaging facility charges more than my plan’s Benefit Amount so I’d like to find the lowest cost. Can you please provide an imaging requisition so I can search for my own provider/[facility]?"

GETTING PRICING FROM EXISTING OR NEW PROVIDERS  

"Can you provide the self-pay price for [imaging service name] including all fees (such as facility fees, test, technical and professional components)? It's important I understand the cash-pay total for my visit ahead of time so I can choose a provider that charges in the range of my insurance company reimburses. I will pay you directly in full for the visit, but I will need an itemized medical invoice."

More questions? Your member care team can't wait to answer them. Chat with a real human on our website or at 855-282-0822. TTY: 711

*Sidecar Health does not utilize a network of providers. External websites and information on healthcare providers, including cost and quality information, is provided for convenience and informational purposes and is not an endorsement or guarantee of pricing, quality, or availability of the provider. Contact the provider for pricing and availability. Sidecar Health bears no responsibility for the accuracy, legality or content of any external websites or for subsequent links from an external site.