New Year Review

Find out what’s changed in your insurance before using it.

Jamaica-born Clover Campbell came to the United States 20 years ago, and in 2012, she officially became a US citizen. The Jamaican-American is proud of her heritage and of her adopted country. Like many Americans, Clover battles several health issues that often require x-rays and other imaging exams. That proved to be a challenge for her.

Patient Clover Campbell describes her experience with LAD imaging in Deltona. Center Director Barbara Borden discusses the importance for people to review their insurance in the new year to learn about any changes so they get the most of their benefits.

Clover regularly depends on LAD Imaging’s services.

After relocating to Florida from New York, Clover started using a local hospital for her imaging needs, but she was dissatisfied there. Then, she was referred to LAD imaging, a fully accredited, outpatient imaging center in Deltona. That change made all the difference in the world to her.

“I had been going to the hospital for my imaging services, but I didn’t like changing doctors,” Clover elaborates. “I wanted to establish a relationship with one doctor, and I could do that at LAD imaging. I also didn’t want to have to change staffs or facilities, and I could stay at LAD imaging and build a rapport with the staff.”

Among the exams Clover has done routinely at LAD imaging are mammograms. Because lumps continually form in her breasts, Clover undergoes a mammogram and ultrasound every six months. When she goes to LAD imaging, she’s happy to see the same skilled staff members perform her exams.

“There’s a cyst in my right breast that’s been removed multiple times, but it keeps growing back,” Clover shares. “I’ve also had lumpectomies in my right armpit, near my breast. That lump returns as well. Fortunately, the lumps have been benign, but I have to follow up on them in case anything changes.

“I love the staff at LAD imaging. They’re really awesome and warm. When I have a lump in my breast, it’s really scary because I don’t know if it’s a cyst or what it is. It’s really important to know the staff. The technologist who does the breast exam always talks to me and explains everything she’s going to do. She educates me, and that calms me.

“Every time she does the exam, I pray, Oh God, thank you for sending this person who always comforts me. Then I get the feeling everything’s going to be okay, and I’m going to be fine.”

LAD imaging calmed Clover’s anxiety about insurance as well. When she needed an exam and was worried about getting treated because she hadn’t met her deductible, the staff at LAD imaging worked directly with her insurance company to be sure Clover could get the exam. Their extra effort impressed her.

“With my insurance, I have a share of costs, like a deductible,” Clover relates. “Most facilities tell me they can’t treat me because of my share of costs. Last year, I had to have an x-ray done on my low back and hip and hadn’t yet reached my deductible. I called LAD imaging, and they said, It’s okay, Clover. Come in, and we’ll take care of you.

“They told me they’d do the exam and send the paperwork to my insurance. LAD imaging accepted me even though I hadn’t reached my share of costs. With them, there was no problem getting treatment. They didn’t say I couldn’t come in. LAD imaging is a real blessing.”

Differences and Deductibles

The beginning of the year is a good time for people to review their insurance benefits, recommends Barbara Borden, center director at LAD imaging. Changes can occur in benefits that people may or may not be aware of. Sometimes, changes occur in patient’s insurance information, or they may receive new insurance cards.

“When patients schedule an exam, they need to let us know if they have a change in their insurance or a new insurance card, including the new Medicare cards,” Barbara stresses. “We always verify insurance before patients come in so they’re aware of what they’ll owe, whether they have a co-pay or a deductible.

“In the new year, we’re required to ask all patients for their insurance cards so we can get the correct contact information from it. Some people get frustrated by this, but we have to do it to verify their insurance and find out if anything has changed for the patients.”

When starting the new year, it’s very important for people to be familiar with their insurance policies – what has stayed the same, what has changed and how any changes are going to affect them.

“Patients need to understand their coverage before they arrive at a physician appointment or a facility for testing,” Barbara states. “Otherwise, they may be surprised to find that the amount of a co-pay has changed, a co-pay is required when none was before or another change has occurred that they were not expecting.”

Barbara recommends that patients pay close attention to policy deductibles and how much is being met with each medical service. Most deductibles start at the beginning of the year. That means they reset to the full amount. For instance, if the deductible is $2,500, the patient will need to pay that much out-of-pocket for covered medical services before the insurance company begins to pay.

“A common misconception is that deductibles must be met all at once,” Barbara describes. “And when patients mistakenly believe costs of a test will be high because a deductible is owed, they may delay a recommended exam.

“For example, a patient who has a five hundred dollar deductible and needs a medical study may believe that five hundred dollars will be required out-of-pocket immediately. However, when insurance companies contract with providers, they set allowable rates for services. The allowable rate for a medical test, such as an MRI, may be less than the deductible, which means the patient will owe less.”

Some people have flexible spending accounts or HR plans through their employers to help them with their deductibles. LAD imaging has a contingency for people who don’t have such plans.

“If patients need an expensive exam, such as an MRI, and it’s going toward their deductibles, we can set up a payment plan,” Barbara explains. “Patients pay a percentage down, then make installment payments to pay off the balance. The payments are generally extended over anywhere from three to six months.”

Comfortable and Secure

Providing quality patient care is LAD imaging’s top priority, Barbara emphasizes. They are fully accredited by the American College of Radiology® and participate in most insurance plans, including Medicare and Medicaid. A commitment to their community is another of the center’s main concerns.

“One reason I chose LAD imaging is because they meet all of my health needs,” Clover says. “Another is because they always work with my church. Every year in October, they provide calendars and support for our breast health event.”

For Clover, those are important reasons for choosing LAD imaging, but the most important reason may be the relationships she’s established with the physicians and staff.

“The rapport that I have with the staff at LAD imaging is why I always make my imaging appointments there,” she confirms. “I feel comfortable and secure knowing that I’m going to LAD imaging for all my imaging needs.

“I will always and have always recommended LAD imaging to others.”

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