I’m under 26 years old and have (supposedly) very good insurance through my dad (Horizon BCBS NJ Educators Health Plan). My cardiologist gave me a prescription to get a CT scan of my kidneys, I would normally go to the same hospital that my doctor works at but I’m away at college in NY so I’m gonna do it somewhere else close to school. I checked online and the facility is in-network.
How can I make sure my insurance is going to cover this? I looked through the plan handbook and it’s so confusing. My plan has no deductible in-network. Radiology is listed as a “service requiring pre-certification,” but weirdly, I don’t actually see it listed as an eligible service. Does that mean if I get precertification I should be good?
I also saw online that radiology places will sometimes have radiology “reading fees,” how can I make sure that’s covered. I’m okay with paying a copay but nothing ridiculous. Is it usually possible to call the place up and ask specifically what codes they will bill, then ask insurance if that’s covered?
I want to be as thorough as possible with all of this. I have been burned before and now I know that doctors don’t really know or care about insurance, they just want money from you.
submitted by /u/throw495887
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I’m under 26 years old and have (supposedly) very good insurance through my dad (Horizon BCBS NJ Educators Health Plan). My cardiologist gave me a prescription to get a CT scan of my kidneys, I would normally go to the same hospital that my doctor works at but I’m away at college in NY so I’m gonna do it somewhere else close to school. I checked online and the facility is in-network. How can I make sure my insurance is going to cover this? I looked through the plan handbook and it’s so confusing. My plan has no deductible in-network. Radiology is listed as a “service requiring pre-certification,” but weirdly, I don’t actually see it listed as an eligible service. Does that mean if I get precertification I should be good? I also saw online that radiology places will sometimes have radiology “reading fees,” how can I make sure that’s covered. I’m okay with paying a copay but nothing ridiculous. Is it usually possible to call the place up and ask specifically what codes they will bill, then ask insurance if that’s covered? I want to be as thorough as possible with all of this. I have been burned before and now I know that doctors don’t really know or care about insurance, they just want money from you.
submitted by /u/throw495887 [link] [comments]Read Morer/HealthInsurance