Billing FAQ

Pre-Exam

What do I need to bring with me the day of my exam?

Bring your driver’s license, passport or state issued identification with a picture ID, complete insurance information, including your insurance card with ID number and group number. In addition, for workers’ compensation claims and automobile injuries, bring your claim number, the date of injury and the name and address of your attorney.

Bring the written order (script) and any other paperwork your physician may have given you.

Bring any prior imaging studies that would help us perform and interpret your exam. If you are unable to obtain these in advance, we will have you sign an authorization form at the time of your exam, and obtain the prior studies for you.

Do I need preauthorization from my health care policy or plan?
Some plans do require pre-authorization. You may contact us and we can provide certified assistance with your pre-authorization requirements. We will need at least 24 hours or more before your appointment to provide this service since many factors and parties may be involved. Your insurance company can also answer any questions you may have about what is covered and what is not.
Does Open Imaging file secondary claims as well as primary ones?
Yes, we will file secondary claims for you.
What if I still have questions after reviewing this web site?
We are happy to answer your questions before your exam begins. We invite you to contact us (greig.huggins@kingsopenimaging.com) or call the location where your exam is scheduled.

Post-Exam

Why do I sometimes get two bills for a healthcare procedure?
The way that medical bills are split out depends on the way your insurance company wants us to bill for your exam. Typically, you will receive two bills for your exams done at Open Imaging. One bill for the technical portion of the scan (what we do), and one bill from a radiologist for the actual interpretation (or reading) of the exam. It does NOT mean that you are paying twice or that you are paying more for an exam, it just means your insurance company has asked us to submit a bill and for the radiologist to submit their bill to the insurance company. A few insurance companies, all self-pay or cash-pay exams, and typically scans done on a lien are billed globally, meaning the technical fee and the reading fee are combined on one bill. In those cases we will submit one bill and pay the radiologist ourselves.
Who do I contact if I have a question about my bill?
Our billing specialists can be reached Monday through Friday from 8:00 AM until 6:00 PM. Please call our main numbers (801-288-9671 for Redwood and 801-852-4040 for our Layton patients). Depending on your question we will direct your call to the proper person.
Can you explain the billing process?
If you have insurance we will bill them for you. We submit our claims within a
few days of your exam. Every insurance company is different. Some require us to collect a co-pay at the time of service. Some don’t. We will contact you prior to the day of your exam and explain what the policy is for your specific insurance.
Most insurance companies also require that the radiologist bill separately for the interpretation (reading) of your exam. If that is the case with your insurance you will likely receive a bill from them within a few weeks of your exam.
That bill will come from Utah Imaging Associates.
Why am I receiving a fee for a radiologist when I never saw the radiologist?
Depending on the type of exam that you received, it is possible that you did not physically meet the radiologist at the time of your exam. However, once your images were taken, they were sent to the radiologist to review. The radiologist then interpreted the scans for any signs of abnormality or disease. They then dictated the results of the study and we sent a copy of that report to your attending and/or referring physicians. When needed, the radiologist also consults personally with your physician to let them know what they have seen on your exam. So, the radiologist is actually very active in your medical care, but sometimes it is behind the scenes! By law, a radiologist must read every medical exam done at out-patient facilities in Utah. They are specifically trained to accurately read your exam and we have contracted with the best radiology group in Utah to read your exam.

Insurance

How much is my procedure if I don't have insurance or don't want to bill it to the insurance that I have?
If you are not billing an exam or procedure to your insurance company (either because you don’t have insurance or because you choose not to), then you are considered a “Self-Pay” patient. Our self-pay (or sometimes called cash-pay) rates for MRI and CT scans are the lowest in the Intermountain West. Click here to see our cash-pay rates.
How much does an imaging exam cost if I have insurance?
There is not one standard price for all MRI exams nor all CT exams. There are hundreds of different types of imaging exams for MRI and CT. These prices vary based on many factors, such as whether it needs to be with or without contrast, how many areas of the body we are scanning etc. Please call us with your insurance information so that we can give you personalized pricing based on your specific exam and insurance.
Does Open Imaging participate with my insurance plan?
Open Imaging is a preferred provider with nearly all insurance plans offered in the Intermountain West. A partial list is included on this website. We are happy to check with your specific insurance plan if you call us with your name, policy number etc. We can be reached at 801-288-9671 for our Redwood patient and 801-825-4040 for our Layton patients.
Will my insurance cover this procedure?
In MOST cases the answer is yes. Your insurance coverage is based on criteria outlined in your insurance plan coverage document. Even if your insurance plan covers the test, you could be responsible for any co-payment, co-insurance, or deductible amounts specified by your insurance plan. We pride ourselves at Open Imaging to verify eligibility with your insurance company and make every effort to get accurate estimates regarding what your portion might be prior to you actually having your exam.
What is authorization?
Authorization (commonly called pre-authorization) is an insurance company’s way of giving you permission to receive an exam or procedure. It essentially means that they must review your doctor’s reasoning for ordering a specific exam before they will agree to pay for it. Many insurance companies will not authorize MRI scans until certain criteria are met. Every insurance company is different. At Open Imaging, we make every attempt to get an exam pre-auth’d for you. We contact your doctor and request necessary documents and submit everything to your insurance company. At times, we find it difficult to get information from your doctor. If so, we will contact you so that you know what is preventing you from having your exam.
How do I know if I need insurance authorization for my procedure?
We are very familiar with this process. We do pre-authorizations all day long. Once you have a scan scheduled at Open Imaging we will contact your insurance and determine exactly what needs to happen to ensure your exam is authorized before we proceed. This process can take 1-2 days up to 3-4 weeks depending on what your insurance company requires.

Co-pays & Deductibles

Will I have an out-of-pocket expense for this procedure?
A: The amount an insurance company pays for an exam is dependent upon the co-pay, co-insurance, and any deductible amounts that need to be satisfied for your specific policy and what type of exam you are having. We highly recommend that you become familiar with your policy, co-pay, co-insurance and deductible amounts. We are happy to explain this if you call our billing department. ALL CO-PAY AND CO-INSURANCE AMOUNTS WILL BE HIGHER AT HOSPITAL OWNED FACILITIES. Please call us before you have a scan done elsewhere.
What is co-payment, co-insurance or deductible?
A: A co-payment (co-pay) is a fixed dollar amount that patients pay for physician office visits, prescriptions or other services. Coinsurance is a defined percentage of the charges for services rendered. A deductible is the amount of eligible expense a person must pay each year from his/her own pocket before the insurance plan will make payment for eligible benefits. With higher deductibles and higher co-insurance the portion you are responsible for could be considerable especially if you have your exam done at a hospital or hospital-owned imaging center. We are happy to explain all of this to you before you have your exam.
If I haven't met my deductible yet, does it matter if I bill my procedure to insurance? I'm just going to be paying for it myself anyway.
A: Allowing your services to be billed to your insurance plan will help to satisfy your mandatory insurance deductible. Once this deductible is met, your insurance provider will then make payment for future allowed services, thus minimizing any future out of pocket costs to you. If you are near the end of the year and you will never meet your deductible you could consider not billing your insurance and paying cash for the exam. Please click here to see our cash-pay rates and policy.
I was involved in an auto accident. My attorney wants me to have an MRI scan. Do you accept liens?
Yes, we are happy to do your scan on a lien basis. The MRI scan must be ordered by a doctor, so we still need a signed request for the MRI (or CT) scan. You will be required to sign the necessary paperwork and it must be approved by your attorney. We then submit a bill to your attorney for the price of the exam. We realize that it might take years for your case to settle, but Open Imaging is more than happy to provide you with this option.