By David Henderson
Two weeks ago I posted about what I thought might be rational pricing for my MRI and I ended by saying “Stay tuned.” I don’t yet have the bill and so I can’t say more about that.
But the story got more interesting. A few days after I posted, I went online with SimonMed, the local in-network (I think) MRI provider to set up an appointment. But it walked me through a whole lot of questions to which I didn’t know the answers. It was almost as if you had to be my doctor to answer them. So I stopped. It had an 866 number but I worried that I would get into the same predicament.
Then I realized that, given that SimonMed is about a block from my office, I could walk over and talk to a human. And a great human she was. I explained that because I’m not a doctor I couldn’t answer some of the questions and she nodded knowingly. I couldn’t see her facial expression because she was masked, but I sensed that she was quite willing to help.
She told me that there had a been a cancellation for the next day and so I could get in then.
Delighted, I walked back to my office and told my wife on the phone. My wife had what she and her doctor feared was a rotator cuff tear and she was in a lot of pain. I told her that maybe I could talk to them about getting her in earlier. Her doctor had sent the referral but we didn’t know where that stood. So I walked back and gave my wife’s information. It turned out that her referral wasn’t as far along for some reason. I called my wife, who was disappointed. So she called her insurer, who then sent her to something called “eviCore.” She called them and was told that someone had canceled her referral and that it “must have been” the doctor. So she called the doctor’s office but everyone must have been in a meeting.
Then I had a thought. I wondered what it would cost if we just skipped the referral and paid for it ourselves. So I went back yet again to Simon Med and asked if we could set up an appointment if we paid for it ourselves. My new friend said we could. “What would that cost us?” I asked. She looked at her computer and said “$500.”
“$500, not $5,000?” I asked, “Are you sure?”
“I’m sure,” she said.
So I set up the appointment for the day after mine.
When I came in for my appointment the next day, the same person I had been dealing with told me that because there had been a mixup about the referral and because it was possible that SimonMed had contributed to it, we would be charged only $350.
The bad news was that the day of my wife’s scheduled MRI, Simon Med called and said that the appointment was postponed by 6 days because the magnets weren’t working. In that case, I joked, maybe they could do simply an RI.
The good news is that last Friday, she got her MRI and I paid $350.
This was better than North Dakota for Canadians!