![]() Under the policy, Anthem subsidiary AIM Specialty Health evaluates whether it is medically necessary for an imaging service to be performed in a hospital setting. In 2017, Anthem issued a policy to limit what hospital-based CT scans and MRIs it covers. However, the policies are likely to have a negative effect on reimbursement for hospitals.īelow is what hospital-based imaging policies look like for Anthem, Cigna and UnitedHealthcare: For example, UnitedHealthcare has found its members could save up to $2,163 on a spinal cervical MRI with or without contrast if the procedure is completed in an ambulatory surgery center instead of an outpatient hospital setting. The insurers say the policies, commonly referred to as "site of service medical necessity reviews," help lower costs for their commercially insured patients.
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