Repeat MRIs:Best Done At The Same Center

I discovered an interesting fact about radiological testing.  There is not a standard image setting for MRI or Cat Scans when being preformed. Nor are machines the same  in quality and maintenance procedures. The settings may be similar but determined at the discretion of the radiology group.  This all came as a surprise to me.

What this means is the images  can be slightly different from one center to another.  One might think, how much different can it be?   For some doctors, it is like comparing apples to oranges.

One doctor told my client, the radiologists can’t read it in the same way because the machines are  uniquely calibrated at each center and the image will  most likely have some differences. In my client’s case, the size of a tumor could not be clearly defined.  Luckily, it didn’t make a change in the  treatment protocol.  Why didn’t the new center do a repeat MRI?   The felt it would be an insurance denial because it was so close to the last imaging.

There is also the issue of the program a center uses to copy radiology studies.  It is not a universal system.   Doctors may be unable to read the disc and need the actual pictures. The problem is, the patient won’t know until the visit delaying viewing and possibly treatment. I witnessed a doctor throw the disc across the room into the garbage bin because his computer program was unable to read it.  Not a happy moment for my client.

It can be important to a patient’s quality of care to get all radiology tests done at one hospital or center. It can be essential for cancer patients in order to have comparable images of tumor changes.

I hear often from medical professionals that they can’t compare the pictures.  It is very frustrating for patients.  One breast cancer client never knew the initial size of her tumor because the images from the original MRI just didn’t match up with the newer images.

Some of the specialty centers charge more for MRIs and CTs and the insurance reimbursement amount may be less.   The new tier insurance plans are a prime example.  Hospitals and medical professionals are tiered by their negotiated charges.  The higher the charge to the insurance company, the less the reimbursement.   The insurance then designates the amount of deductible and coinsurance the patient has to pay.  A copay for an MRI at the most expensive center, can run as high as $500 with the rest being put on the deductible.  The lowest can have no deductible or copay

This new system is supposed to offer patients a way to save money.  The down side is shopping around for MRIs that need to be compared with older imaging may cause problems.   If a client makes the change, I encourage them to stay with that imaging center for continuity.