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ADIN Healthcare Identifies the Top Six Ways Employers Lose Money on Diagnostic Testing for Workplace Injuries
Date:11/18/2009

's understandable employers would want to use lower cost diagnostic tests. However, going with the lower cost option could end up costing considerably more in the long run by extending disability and increasing total medical costs. For example, while computed tomography (CT) scans are less costly for certain injuries (i.e., low back strains), beginning with a magnetic resonance imaging (MRI) exam may actually save money by giving the treating physicians a better opportunity to make an accurate diagnosis. Prompt, appropriate testing can help diagnose the injury early on and ensure recommended treatments are begun quickly. Waiting may mean an employer pays for the initial CT and a subsequent MRI if the treating physician is unable to accurately diagnose the injury the first time.
  • Poor oversight of diagnostic vendors. While diagnostic testing is a critical tool, it can be over-used resulting in wasted benefit dollars. Employers need to ensure their network providers and TPAs carefully monitor billing from diagnostic vendors. For example, some vendors routinely perform and bill for 3-D reconstructions. However, according to the American College of Radiology (ACR), 3-D codes should be reserved for situations where additional imaging is necessary for surgical planning or for a complete depiction of an abnormality from a two-dimensional study. In many instances, 3-D reconstructions are simply not necessary for CT scans and virtually never indicated with an MRI. Ensuring these codes are billed and paid only when appropriate can help payers manage their diagnostic costs.
  • Delaying necessary testing. Some employers and even providers take a 'wait and see' attitude when it comes to injuries, believing it may get better on its own. Others are forced to delay treatment because a recommended test is unavailable through network providers or there are delays in scheduling. Diagnostic scheduling providers, such as ADIN, can help ensure that th
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  • SOURCE ADIN Healthcare
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