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Various Diagnostic Tests covered under Instant Affordable MEDICAL CARE INSURANCE Plans

The whole purpose of the affordable health insurance act is that everybody should be able to get required health treatment. That’s why we Americans are purchasing the coverage plans and are ready to pay the premiums.
But in hurry, if we usually do not investigate the plans properly, then we may have to pay excess amount on and above the premiums. One particular thing is the diagnostic tests that are required today for various health treatments.

Here we shall see how and that will be covered in our coverage plan.

Radiological and Pathological Services to Hospital Inpatients Effective April 1, 1968, reimbursement may be made under Part B for the full reasonable charge for radiological and pathological services furnished to inpatients of a qualified hospital (i.e., one which meets all the conditions of Medicare participation) by way of a physician in the field of radiology or pathology.

This means that 100 percent reimbursement will undoubtedly be made for the reasonable costs for such services, at the mercy of neither the usual deductible nor coinsurance features.

A. Definition of Radiological and Pathological Services The word "radiological services" means services where x-rays or rays from radioactive substances are used for diagnostic or therapeutic purposes. Such services include but aren't limited by radium therapy, the use of radioisotopes for diagnostic or therapeutic purposes (as in nuclear medicine), and diagnostic tests such as for example angiograms, aortograms, pyelograms, myelograms, arteriograms, ventriculograms, etc.

The word "pathological services" identifies services performed in both clinical and anatomical pathology.

Included are microbiological, serological, chemical, hematological, biophysical, cytological, immunohematological. and pathological examinations performed on material derived from the body, to supply information for the diagnosis, prevention, or treatment of a disease or assessment of a medical condition so it is necessary to have instant affordable medical insurance.

Such tests as BMR's, EEG's, and EKG's are considered to be neither radiological nor pathological services. Therefore, reimbursement for such tests can be made only at the 80 percent rate, after recognition of the deductible, and the combined billing method may not be used for such services rendered to hospital inpatients.

NOTE: Reimbursement can be made at the completely rate for only those radiological and pathological services performed by physicians in the fields of radiology and pathology.

B. Field of Radiology or Pathology Your physician in the "field of radiology or pathology" includes not only a specialist in one of those fields, i.e., a radiologist or a pathologist, but additionally a physician who normally performs or supervises the radiological or pathological services for patients of a specific hospital, despite the fact that the physician does not otherwise specialize in radiology or pathology.

An example of this situation is a small hospital which has no radiologist but designates another physician to take care of or supervise the hospital radiological procedures. The entire reasonable charge for the radiological services of the physician rendered in such a capacity would be covered. Alternatively, the reading of an x-ray film as part of his usual services for his own patients by, for example, an attending physician or a surgeon would normally be covered only as regular physicians' services, i.e., the basis for reimbursement will be 80 per cent of the reasonable charge, subject to the $50 deductible.

These tests requires significant amount of dollars. So or even covered, then we need to pay these through our very own pockets. So be careful when you are getting the coverage plans.

Don't be the product, buy the product!