A friend asked the other day if it was possible to shop for an MRI. I sent him our “10 questions to ask” post, and after a little while, he emailed me to say he had a shoulder MRI for $600 at Union Square Imaging in New York. I asked him if he could tell me a little more about the process, and he sent this from his administrative assistant:
“Ha! I just followed your instructions. Basically, I pushed back on everything they suggested because I knew you wanted the MRI and were willing to pay out of pocket. And, I knew it would eventually be reimbursed by [his executive health plan]. …
“If helpful, here’s how it happened:
“Background: I knew you had a massage therapist, a physical therapist and had already seen your primary care doctor. Since your PC had recommended an X-Ray because insurance would cover that over an MRI, I figured he’d approve an MRI and / or at least you had documentation to indicate that you needed some sort of test.
“As you suggested, I called the closest radiologist, which was Union Square Diagnostic Imaging. I told them you wanted an MRI for your shoulder and that you would pay out of pocket. They had asked if you were referred by your doctor. I told them that you had been referred for an X-Ray, but that the place didn’t accept appointments and you were too busy to just show up and hope for the best. I reiterated that you wanted an MRI, that you were able to pay out of pocket and that you wanted to set an appointment.
“They then asked questions about your injury and if you were doing anything about the pain. I provided all the background info above, your weight, height and your birthday. From there, they booked the appointment but said you needed to bring documentation from your doctor that said he referred you for an MRI.
“From there, I called the doctor’s office and said that I had booked you an MRI and that you needed an updated referral. At first they said they’d handle it and would send over the forms. Then, they called back to say the referral was for an X-Ray only because insurance wouldn’t cover an MRI. I said that you were going to pay out of pocket and that I had already booked an appointment. There was some pushback about them wanting you to get an X-Ray first, but I said that you were set on getting an MRI.
“I don’t know what happened internally, but eventually they called back to say that your PC had referred you for an MRI and all of the paperwork had been sent over to Union Square Diagnostic Imaging. She made sure we both understood that it wouldn’t be covered by insurance. I think it really helped that I was calling on your behalf, because I just basically repeated, ‘This is what he wants. I’m sorry to be difficult, but he doesn’t want to get an X-Ray. He wants to pay out of pocket, etc.’ It’s hard to tell someone no when they’re not personally involved.”