Houston Medical Imaging is the #1 choice for many doctors when it comes to referring their patients for imaging exams as well as for patients who are actively involved in deciding where they want to have their imaging exams performed. With the convenience of five locations throughout Houston, free parking, evening/weekend hours, on-line access for doctors and patients to view imaging reports, it’s no wonder that HMI has continued to expand their footprint in the Houston community. Providing patients with access to quality care and state-of-the-art equipment at affordable pricing, has been and will continue to be the focus for HMI.
With renovations underway for their new location in Pearland, which will open early fall of 2019, HMI is also proud to
announce, that they have expanded their office support staff, and in the process, created new jobs within the market place. The expansion has included a new office to house the insurance and authorization departments. I sat down with Laurissa Ayala, who is the Insurance/authorization manager at HMI, and got her perspective regarding the new growth’s impact on her position, her team, and ultimately the patient experience.
We all know how complicated and frustrating it can be talking to our insurance providers. The majority of us don’t really know the “ins and outs” of our plans, let alone fully understanding what benefits we actually receive from our insurance plan or how to apply our deductible. How many times have you received an expected bill after seeing a physician and or you show up to your appointment, only to find out you have to pay something before you can be seen? We have all experienced that negative surprise.
Unfortunately, each insurance company’s plans are different, so it’s not easy to come up with a simple explanation of benefits across the board. It takes a unique group of individuals to understand insurance plans and be able to explain what benefits are available within the plan.
The HMI insurance and authorization team manage the insurance associated with an imaging study. They verify the patient’s insurance plan to discover what it will cover (benefits), what out-of-pocket costs the patient is anticipated to-pay, and ensure authorizations are received prior to the patient having an imaging exam. The above-mentioned tasks take place behind-the- scenes and before the patient ever arrives to an HMI location, but they are extremely important to the patient and let me tell you why. Firstly, if the insurance plan is not verified, meaning the benefits are not checked, you as the patient may end up paying for services that your insurance plan will not over.
Secondly, an authorization (decision from your health insurer or plan that the service being requested is medically necessary) is required for high-tech imaging such as MRIs and CTs, an authorization is needed from the insurance company and must meet insurance guidelines. It is the responsibility of the staff to ensure all criteria is met and if not, to discuss with the referring physician if additional information is needed. If a proper authorization is not received prior to the imaging study, the claim will be denied, meaning the insurance provider will not pay the claim. Needless to say, it is vital that an authorization is received prior to having an exam.
The HMI insurance and authorization team works closely with referring physicians who are trying to help their patients schedule diagnostic studies. “It’s essential that we all work together as a team to care for patients,” states Laurissa. “Patients are already stressed about their imaging study as well as their financial responsibility and not having good or accurate information adds a whole new level of anxiety. It’s our job to ensure that each of our patients has a clear understanding of their benefits, so when the time comes for the imaging exam, they can be rest assured that they will not be surprised with an unexpected bill.”
While I sat and observed the team, I could tell that they spent a great deal of time speaking with patients. They did an excellent job explaining insurance plans, making sure the patients understood out-of-pocket costs, or discussing cash options in the event that paying cash was a cheaper option than going through their insurance. That may sound crazy, but its true! It is always advisable to know your options in order to make informed decisions.
HMI even takes an extra step to send a text message to every patient once the insurance verification and authorization has been completed to include the exact dollar amount that may be owed prior to their imaging study. This may seem redundant, but this is one more method of communicating with the patient and keeping in line with our mission to be transparent.
Laurissa has worked with Houston Medical Imaging for nine years and previously worked for a medical billing company, where she gained great knowledge on revenue cycle management (medical billing process). She has found HMI to be a great place to work and is proud of her work as well as her role within the company. She said that Dr. Stenoien is always encouraging the staff to treat patients as if they were family members, “We take our time with each patient or physician that calls us. We love being in an environment that actually caters to the patient and their experience. If we drop the ball on something, we as a team will use the experience to learn and improve our process or customer service.”
According to Laurissa, the administration at HMI is constantly trying to improve not only the patient experience, but also is continually investing in technology that assists staff members to deliver exceptional results. One such project is a proprietary software that the IT team has been working on called “The King”. Laurissa describes this software as a tool that will assist the whole team at HMI to improve their production and results, thus benefiting the patient and referring physicians. “Our goal every day, is to run a consistent and thorough process, I believe that this is what sets HMI apart from other facilities in Houston. We want the patient experience to be as pleasant, friendly, and comfortable as possible.”
Laurissa is a diamond that shines bright when it comes to assisting patients understand their individual insurance plans. “I find great joy and satisfaction in helping people. I absolutely love what I do, as I know that I along with our team, are making a difference, even if it’s one person at a time.”
Laurissa’s sweet smile and gentle eyes portray her passion while she is talking about her team and everything they do on a daily basis. Managing a billing team seems like a piece of cake for Laurissa considering that she is also raising three teenage sons. When she is not at baseball tournaments cheering on her sons, she enjoys being with her family.
If you have any questions about your health benefits or need to schedule an imaging exam, Laurissa Ayala and her team are ready to assist and will answer your questions.
We are very appreciative of Laurissa and the entire insurance and authorization team at HMI for their hard work and dedication to our mission in delivering exceptional quality patient care.
For more information please visit our website or to speak with one of our representatives, please call our office at: 713-797-1919 or visit our website