Imaging Cost & Quality Program

In 2010, we initially launched our imaging cost and quality program to help educate members about their options in choosing high-quality, lower-cost imaging services. After all, the more informed you are about your health care and the associated costs, the more likely you will be to use your health care dollars wisely.
The cost of advanced imaging procedures has increased in recent years, contributing to higher medical costs. For example, the cost for MRIs and CT scans can vary from $350 to $2,000, depending on the region where you live and the facility where a procedure is performed.
That means if you pay for a percentage of your care, instead of a co-payment, you may end up spending hundreds of dollars more for a certain procedure than you would if you chose treatment somewhere else – often within a few minutes' drive.
Anthem is committed to helping you have access to the right care at the right time and in the right setting. We think you’ll find our imaging cost and quality program to be a valuable tool in helping you make more informed health care decisions.
((Click on question to see answer))
Q. What are imaging services?
A. Imaging services give you and your doctor an image of the inside of your body. Examples are MRIs and CT scans.
Q. How does the imaging cost and quality program work?
A. When you need a diagnostic imaging service such as an MRI, we let you know which providers in your area offer quality service at low cost.
Q. What procedures are included in this pilot program?

A. MRI, CT scan, magnetic resonance angiogram (MRA) and computed tomography angiography (CTA).

Q. How does this program benefit me?
A. You may be able to get quality care at lower out-of-pocket costs. This is especially true if you pay a coinsurance (a percentage of the cost) rather than a copay (a flat dollar amount for each service).
Q. How much money could I save by visiting a lower-cost imaging provider?
A. In some areas, the cost for an MRI or CT scan can vary by more than $1,000. If, for example, your plan requires you to pay a 20% coinsurance, and you use a provider that charges $1,000 less, you could save at least $200 out of pocket.
Q. How can you tell if an imaging provider’s services are the same or higher quality?
A. We use a tool developed by AIM Specialty HealthSM to gather information from imaging providers about their staff, equipment, accreditations and quality control measures. The tool then gives us a quality score we can use to compare different imaging providers.
Q. How do I know if the quality is the same?
A. We suggest providers for you based on the quality score first, and cost second. So you only need to consider providers that would give you the same or better quality service.
Q. Can I view the cost and quality data on my own?
A. Some of it. You have access to Anthem Care Comparison on our website. There, you can compare costs for imaging and other outpatient and inpatient services.
Q. Is the imaging cost and quality information available to the general public?
A. No. We offer this only to our members and our network imaging providers at this time.
Q. My doctor referred me to a certain provider – why are you trying to get me to use a different one?
A. The program tries to make you aware of options you may not know about. But it doesn’t replace the advice of your doctor..
Q. If I choose a lower-cost provider, can Anthem help me make an appointment there?
A. Yes. When you call to let us know you want to use a lower-cost provider, we’ll try to reach them and connect you to set a time. If we can’t connect you at that time, we’ll give you the provider’s number to call back at a later time.
Q. What if I choose NOT to use the lower-cost provider?
A. That’s your choice. You don’t have to use the lower-cost option.
Q. I’m not ready to choose right now on the phone. Who do I call at another time?
A. You can call 877-309-4886 to speak to one of our representatives.
Q. Can providers see the imaging cost and quality information? How does that benefit me?
A. Yes, they can. Our reports show what procedures are ordered, for whom and where they can be done. We realize that providers are also concerned with cost and quality. So we hope the program will encourage them to find ways to keep quality high and costs down.