Digital Sharing for Medical Images: PACS vs. VNAs

Digital Sharing for Medical Images: PACS vs. VNAs


Health care providers are virtually required to have digital infrastructure that includes sharable medical images these days. But if you’re looking to upgrade your system, or you’re implementing your first digital image archive, you have many software products to choose from.


The leading technologies for storing and retrieving medical imaging files are picture archiving and communications systems (PACS) and vendor neutral archives (VNAs). While the two competing formats look similar on first glance, there are notable differences between them. Before we get to the contrasts, though, it’s important to note what PACS and VNAs have in common. Here are a few of the constants across both types of imaging technologies:


  • Both PACS and VNAs provide remote access to images. Radiologists can upload images on one terminal, while physicians in a different office can log in to access them. This is the crucial requirement of all digital image-sharing systems.


  • Both systems operate with the same file format and transmission protocol: DICOM, which stands for “digital imaging and communications in medicine.” File formats can lead to accessibility problems, as each application is only equipped to handle certain types of files. The universal use of DICOMs between PACS and VNAs seems to suggest that migrating images between the two systems would be seamless. Unfortunately, that’s rarely the case. We’ll get into that a little later.


  • Both options may or may not also operate as a platform for non-DICOM images. This is an important question to ask when considering changes to an image-sharing system for medical care. If departments other than radiology are hoping to upload and access images through the same system, it is vital to choose software that can support non-DICOM images.


  • Designers of both PACS and VNAs are working to improve mobility and access to images across different types of devices. That’s one of the leading requests by radiologists and other health care providers — physicians want to be able to call up an image, safely and with full HIPAA compliance, on a tablet or even a phone in the examination room with their patients. They also want access at office desktops for consultation and reporting.


Despite these similarities, PACS and VNAs have very different sets of advantages. To complicate matters, many PACS are beginning to provide some of the features that initially launched the popularity of the VNA. Before making a system-wide purchase (or subscription service, which is also available from many vendors), it’s important to consult all stakeholders in your health care system, and to get to know your vendor and their product well.


That said, there are some broad-strokes difference between your average PACS and a typical VNA. We’ll get into those next.


PACS vs. VNAs: Differences Between Medical Image-Sharing Platforms


According to the trade publication Diagnostic Imaging, the VNA tends to focus on archiving and backing up data, while the PACS usually emphasizes workflow and user experience. Of course, these general principles are less significant in today’s market, where there are a wide variety of VNAs and PACS, and their strong points have begun to overlap.


That said, here are some of the differences between PACS and VNAs that users and medical industry analysts have pointed out:


  • The PACS is the original technology used to archive and retrieve digital medical images. As such, it’s often the choice of individual radiology departments, which were among the first to adopt digital imaging. VNAs, on the other hand, are more often found in multiple departments.


  • PAC systems are more highly proprietary than most VNAs. That is, each individual PACS will require its own user interface and its own log-in information. VNAs were designed to support storage and access across systems and vendors. Of course, new developments in PACS technology renders this difference conditional, but it remains the conventional wisdom among medical technology experts.


  • A VNA, by definition, divorces the storage/access functions of a PAC from a particular workstation or data silo. It uses its own application engine, allowing users to access images from multiple sources with the same user interface. That’s what makes VNAs typically better for interoperability between systems compared to a traditional PACS.


While the above list does seem to argue for the dominance of VNAs over PACS, in actual practice, implementation isn’t always the best choice for every provider. It can be expensive and time-consuming to migrate data from an existing PACS to a brand new VNA.


That’s because DICOM files contain both metadata and location pointers. The former attached patient information to the image; the latter helps the system find and pull up the specific image the user searches for.


During transition, all of this supplemental information can become scrambled, preventing access to images. In order to avoid this outcome, vendors often must reset DICOM headers and location pointers to ensure accuracy and access in the new system. That can be a lengthy and cost-intensive process.


Ultimately, then, institutions with the time and the money will benefit from an upgraded VNA system. More practically, some users will choose a PACS, with or without newly developed features. Regardless of the archiving and retrieval system, digital transmission for diagnostic images is practically a requirement in today’s medical system. Choose an imaging software product that makes it easy to share images with other departments and institutions.




Jackson, Whitney. “What You Need to Know About VACS and VNA.DiagnosticImaging.” UBM, 4 Sept. 2014. Web. 15 Oct. 2018.  


O’Dowd, Elizabeth. “Pros and Cons of PACS, VNAs for Medical Image Data Storage.HitInfrastructure. Xtelligent Healthcare Media, LLC, n.d. Web. 15 Oct. 2018.


5 Ways Physicians Can Keep Imaging Costs Down for Patients

According to the American Medical Association (AMA) Code of Medical Ethics, “Managing health care resources responsibly for the benefit of all patients is compatible with physicians’ primary obligation to serve the interests of individual patients.” In other words, doctors should consider the cost of treatment, and save their patients money when they can.


At a time of record health care costs — more than $28,000 for the typical U.S. family in 2018 — this isn’t just an issue of saving patients a few dollars here and there. When patients can’t afford to pay their health care bills, they’re more likely to delay seeking treatment. That delay can affect the outcome of eventual care.


Of course, as the AMA states, “Physicians’ primary ethical obligation is to promote the well-being of individual patients.” Sometimes that well-being hinges on cash or its lack. So how can general practitioners and other referring physicians limit the cost of care for their patients? Diagnostic imaging is a great place to start. The cost of imaging studies has grown faster than wages, overall inflation, and health care expense.  


Luckily, doctors are pushing back against hospital pricing for these services. Here are a few ways referring physicians can provide excellent care for their patients without overspending on imaging studies:



  • Involve patients in the decision to seek or omit imaging tests. When a patient presents with conditions that aren’t life threatening, doctors have significant leeway to work within the patient’s preferences. Often, this leads to fewer imaging studies, with associated savings. In a recent study, doctors who used shared decision-making tools with their patients ordered 7 percent fewer advanced imaging tests and 30 percent fewer standard imaging studies.  




  • Avoid ordering full-body scans to screen for tumors unless patients show symptoms. The American College of Preventive Medicine discourages the use of whole-body scanning to screen asymptomatic patients for tumors. They point out that no data suggests survival improvement for patients, and that less than 2 percent of asymptomatic patients screened had tumors.
  • Choose imaging providers with upfront pricing, and share that information with patients. It shouldn’t be difficult to find pricing for imaging procedures before making a referral. If a provider conceals prices, choose another imaging clinic. With accurate pricing information in hand, physicians can work with patients to conduct a cost-benefit analysis of ordering a study.




  • Refer patients to high-quality imaging clinics rather than relying on hospital radiology departments. As we’ve mentioned in this space before, an MRI from a freestanding independent imaging center is often thousands of dollars less than the same procedure at a hospital — even with the same doctors and the same equipment. Choosing a high-quality imaging provider that’s free from hospital pricing is the easiest way to save patients money on diagnostic tests.  




  • Take advantage of digital delivery of diagnostic images and radiology reports. Doctors and patients can access digital reports anywhere and at any time, leading to lower costs and greater access. Precise Imaging offers doctors digital access and 24/7 tech support through a dedicated physician’s portal.



With the ongoing public discussion of the U.S. health care system, awareness of the role of finances in treatment continues to rise. It’s time to have these discussions; as of 2013, only 36 percent of surveyed physicians believed they had a “major responsibility” to control care costs on their patients’ behalf.


But we know that affordability can translate into real-world effects on outcomes. Patient well-being and the costs of care are not two separate issues; they are bound together in complex, intractable ways. By choosing dedicated, patient-centered providers like Precise Imaging, doctors can get patients the services they need without unnecessarily adding to their burden of medical debt. Call us at 800-558-2223 or fill out our online form to make a referral today.   




Bradley D, Bradley K. The value of diagnostic medical imaging. North Carolina Medical Journal [serial online]. March 2014;75(2):121-125. Available from: MEDLINE Complete, Ipswich, MA. Accessed August 16, 2018.


Choosing Wisely, an initiative of the ABIM Foundation. American College of Preventive Medicine: Five things physicians and patients should question. Choosing Wisely. [online]. February 25, 2015. Available from Accessed August 16, 2018.


Herdman MT, Maude RJ, Chowdhury MS, et al. The Relationship between Poverty and Healthcare Seeking among Patients Hospitalized with Acute Febrile Illnesses in Chittagong, Bangladesh. Ali M, ed. PLoS ONE. 2016;11(4):e0152965. doi:10.1371/journal.pone.0152965. Accessed August 16, 2018.


O’Reilly K. The AMA Code of Medical Ethics and health care spending. AMA Wire. [serial online]. April 18, 2018. Available from Accessed August 16, 2018.


Rainey M. Health care costs for typical American family hit record high. The Fiscal Times [serial online]. May 23, 2018. Available from Accessed August 16, 2018.


Smith-Bindman R, Miglioretti DL, Larson EB. Rising Use Of Diagnostic Medical Imaging In A Large Integrated Health System: The use of imaging has skyrocketed in the past decade, but no one patient population or medical condition is responsible. Health affairs (Project Hope). 2008;27(6):1491-1502. doi:10.1377/hlthaff.27.6.1491. Accessed August 16, 2018.


Tilburt JC, Wynia MK, Sheeler RD, et al. Views of US Physicians About Controlling Health Care Costs. JAMA. 2013;310(4):380-388. doi:10.1001/jama.2013.8278.


The World Bank. Poverty and health. The World Bank. [online]. World Bank. August 25, 2014. Available from Accessed August 16, 2018.


Veroff D, Marr A, Wennberg DE. Enhanced support for shared decision making reduced costs of care for patients with preference-sensitive conditions. Health affairs (Project Hope). 2013;32(2). Accessed August 16, 2018.


Insurers Demand Independent Imaging Centers: What Physicians Should Tell Patients

Independent imaging centers are moving to the forefront of diagnostic care in the United States. Recently, at least one major health insurer dropped coverage for CT and MRI scans at hospital radiology facilities. The insurance company will only pay for these scans when patients visit providers who specialize in diagnostic imaging, and imaging alone.


How will this change the conversation between referring physicians and their patients? In order to explain the changes — why insurers would make a rule like this, and why it’s not at all a bad change for patient care — physicians need only look at two key metrics of today’s health care system: price and quality.


The Price Difference Between Hospitals and Independent Imaging Centers


When an insurance company makes a move like this, it’s a clear indication that there’s a wide price differential that’s not necessarily associated with a difference in quality of care. Research from the Healthcare Financial Management Association — a professional organization for people who work on the financial side of the health care industry — shows that prices at hospitals are, in fact, dramatically higher than those at the average free-standing imaging provider. Among other differences, the HFMA found:


  • MRI scans cost an average of 70 percent more at hospitals than at independent imaging centers.
  • When those MRI scans covered the head and/or neck, they were an average of 80 percent more expensive in hospital-owned facilities.
  • The differences were even more stark for CT scans. Imaging of the body using CT cost 135 percent more at hospitals.
  • For CT scans of the head and/or neck, patients paid an average of 149 percent more at hospitals than at free-standing imaging facilities.


This research was published in 2017, though most of its data came from 2014. Either way, price gaps remains.


Measuring the Quality of Diagnostic Imaging Providers


Patients are used to associating higher prices with better service. In health care, however, quality and cost are independent of one another. The United States has the most expensive health care in the world.


In 2014, U.S. health care spending per capita was $9,237. That year the United Kingdom spent $3,749 per person while Japan’s figure stood at $3,816. Still, among the 12 wealthiest industrialized nations — including Japan and the UK — the United States lands dead last in terms of life expectancy.


Clearly, spending more does not buy better care in this country. In fact, independent imaging centers offer measures of quality, in terms of better patient experience, that most hospitals cannot boast. At Precise Imaging, these include:


  • Evening and weekend hours to work around the patient’s schedule, not the other way around.
  • Excellent, board-certified radiologists and technicians, often the same ones hospitals use, at a drastically reduced cost.
  • Quick reporting with HIPAA-compliant online sharing with referring physicians. Most doctors are reading radiology reports within 24 hours of the scan.
  • Same-day scheduling.  
  • Transparent pricing.


There have been plenty of good reasons to refer patients to a free-standing imaging facility for years. Now that insurers are refusing to support the arbitrary and inflated costs that hospitals charge, more and more patients will be able to experience the care that Precise Imaging provides.


Medical Imaging for Personal Injury Claims Involving Car Accidents

Medical Imaging for Personal Injury Claims Involving Car Accidents


Personal injury claims require a serious burden of proof, and medical imaging can be the case-deciding factor. Even when doctors decline to order MRI scans, lawyers themselves can sometimes schedule a diagnostic imaging procedure for their clients.


Here’s what attorneys should know about pursuing medical imaging procedures for their patients who have been injured in at-fault car accidents:



Some MRI scans do not require a physician’s referral.



You can divide MRI scans into two general categories: those that require an intravenous contrast agent, typically a harmless element called gadolinium, and those that don’t. The former do require a doctor’s order, but a simple MRI scan, without the use of contrast agent, may not require an initial doctor’s referral



Most other medical imaging procedures do require a doctor’s recommendation.



Many of the leading technologies radiologists use to diagnose injuries and illnesses expose patients to a small dose of ionizing radiation. It’s small, but over a patient’s lifespan, the exposure accumulates. That’s why radiologists generally do require a physician’s referral before proceeding with tests such as X-rays, CT scans, and arthrograms.



Doctors often order MRI scans in cases of suspected cases of spinal injury and soft tissues.



MRI scans are particularly well-suited to imaging soft tissues, such as ligaments, muscles, and nerves. Injuries associated with car accidents — including whiplash and herniated discs — often involve these soft tissues. So this imaging modality is particularly well suited to common injuries that result from car accidents.



Rear-end collisions frequently lead to whiplash and spinal cord injuries.



When one driver rear-ends another, causing injury, half of the attorney’s job is already done: It’s usually simpler to assign fault in rear-end collision cases.


However, they still have to convince the judge that the patient was truly injured. Because this type of wreck often leads to soft-tissue injuries, MRI scans might be the ideal imaging modality to show to prove the negative effect of the accident on the plaintiff’s health.



Precise Imaging can provide MRI scans on a tight deadline.



Some personal injury attorneys spend hours calling around to diagnostic imaging providers, looking for a quick MRI before a case goes to court. The better solution would be to rely on a consistent resource with an imaging provider that understands the role of diagnostic imaging in legal cases — a provider like Precise Imaging.


Precise Imaging has experience serving attorneys and their clients in the Los Angeles area and beyond. We offer specialized resources just for attorneys, and accept personal injury liens as well as letters of protection. There’s even a dedicated web portal just for attorneys, complete with 24/7 IT support.


We also understand that, in law, timing is of the essence. That’s why Precise Imaging’s locations offer expedited, 24-hour service on radiology reports with tight deadlines.    


The next time you file a personal injury claim for a client who was injured in a car accident, remember the value of diagnostic MRI scans. Call Precise Imaging at 800-558-2223 to learn more.



sports medicine diagnostic imaging

Diagnostic Imaging for Sport and Exercise Medicine (SEM) Specialists

Diagnostic Imaging for Sport and Exercise Medicine (SEM) Specialists


Sports physicians and radiologists work together to quickly diagnose and treat the musculoskeletal injuries associated with frequent physical exertion. Still, sport and exercise medicine (SEM) remains a young specialty — it wasn’t until 2005 that the United Kingdom’s Department of Health granted SEM official specialty status.


So it’s a good time to ask the question, both of sports physicians and radiologists themselves: How can this close working relationship improve as both specialties develop? What exactly do sports physicians need from their diagnostic imaging providers, and how can those providers tweak their processes to work better with SEM specialists and their patients?


Here are a few thoughts, culled from the extant literature:

  1. Help provide actionable images to help decide when it’s safe for athletes to return to the field
  2. Assist with screening efforts and pre-play assessments;
  3. And they can provide “technical assistance with certain procedures.


Diagnostic imaging providers have much more to offer SEM physicians than confirmation of a given diagnosis.



According to I. McCurdie, FRCP, FFSEM(UK), writing in the British Journal of Radiology in 2012, “confirmation of accurate diagnosis” is only the first area in which radiologists can support sports physicians. They can also:


Sports physicians, in other words, need access to imaging providers who can respond to a wide range of needs. It makes sense for an SEM specialist to create relationships with established, trustworthy networks of imaging providers like Precise Imaging. With the range of expertise, simple systems for billing and referral, and an online portal just for physicians, Precise Imaging can respond to the immediate needs of SEM specialists and their patients.


Elite athletes often need incredibly quick turnaround on radiology reports.


When high-level athletes get injured, their managers want them back on the field as soon as it’s safe. Team physicians typically don’t have time to wait for a several-day turnaround to get their radiology reports.


Radiologists must be physically present, at imaging facilities or even on the field, in order to produce accurate reports a quickly as possible. Precise Imaging radiologists always work on-site at their facilities, and they average a turnaround of 24 hours, with available same-day referral service.



Sports physicians require access to multiple imaging modalities from the same provider.



“The range of pathologies and different tissues injured during sport and exercise determine the imaging modalities used,” writes McCurdie. “With soft-tissue injuries being common, the opportunity to image with ultrasound during functional movements (often as an extension of the clinical examination) and avoid any exposure to irradiation makes this a very useful tool.”


At the same time, MRI scans reveal soft-tissue injuries and have been successfully used to diagnose muscle damage accurately. Still, many physicians prefer to begin diagnostic imaging efforts with radiography.


“Plain X-ray should still generally be the first imaging technique,” wrote John Orchard et. al in the Medical Journal of Australia in 2005. In that article, “The use of diagnostic imaging in sports medicine,” Orchard and the other authors pointed out a few exceptions to the guideline of defaulting to X-ray.


“Exceptions include some forms of superficial tendinopathy, in which ultrasound may be more appropriate, and situations where radiation exposure is contraindicated, such as in a pregnant patient,” they wrote.


Precise Imaging locations offer multiple imaging modalities, often with a full range of options for each. So patients with musculoskeletal injuries associated with sports and exercise can visit a single outpatient clinic for ultrasound, X-ray, MRI, and/or CT scans, all with simple, convenient scheduling.



While all imaging modalities have their uses in sports medicine, MRI scans are sometimes crucial for the diagnosis of one of the most common knee injuries in sports: the ACL tear.



Klass et al. point out that MRI scans are a central component to care for patients with chronic knee conditions. In their literature review, though, the authors found that MRI was increasingly paying dividends in cases of acute injury, particularly a tear in the anterior cruciate ligament (ACL).  

Of course, physicians can often diagnose ACL injuries without the use of MRI technology. However, Klass and colleagues conclude, “It should be realised that significant advances are being made, and that there may be an increasing use of MRI in the management of the acutely injured knee which will include rupture of the ACL.”


Precise Imaging for Patients of SEM Specialists


SEM physicians and their patients benefit from diagnostic imaging facilities that:   


  1. Are capable of multiple imaging modalities;
  2. Remain available for expanded hours, including weekends and evenings;
  3. Offer quick, simple scheduling, including same-day service and ride assistance;
  4. Employ radiologists with experience in musculoskeletal injuries associated with sports and exercise, who carry full board certification, and who work on-site at the place of testing;
  5. Are able to handle a variety of payment types, including insurance, Medicaid and Medicare, personal injury liens, and even low cash options for uninsured patients;
  6. Operate large networks of outpatient clinics, ensuring availability and flexible scheduling.


Patients under the care of an SEM specialist will benefit from the friendly and efficient service of the Precise Imaging team. If you’re a referring physician and you’re looking for a new imaging partner to help with a sports and exercise medicine practice, contact Precise Imaging at 800-558-2223 today.




Cullen M, Batt M. Sport and exercise medicine in the United Kingdom comes of age. British Journal of Sports Medicine. 2005;39(5):250-251. doi:10.1136/bjsm.2005.019307


Gibbs NJ, Cross T, Cameron M, Houang MT. The accuracy of MRI in predicting recovery and recurrence of acute grade one hamstring muscle strains within the same season in Australian Rules football players. Journal of Science and Medicine in Sport. 2004;7(2):248-258. [PubMed]  


Klass, D et al. MR imaging of acute anterior cruciate ligament injuries. The Knee. 2007;14(5):339-347. doi:10.1016/j.knee.2007.04.008


McCrory P. What is sports and exercise medicine? British Journal of Sports Medicine. 2006;40(12):955-957. [PubMed]


McCurdie I. Imaging in sport and exercise medicine: “a sports physician’s outlook and needs.” The British Journal of Radiology. 2012;85(1016):1198-1200. doi:10.1259/bjr/14729770


Orchard, J, Read J, Anderson I(J)F. The use of diagnostic imaging in sports medicine. The Medical Journal of Australia. 2005;183(9):482-486. Available from:

No health Insurance

Diagnostic Imaging Referrals for Uninsured Patients

What should physicians do when they suspect a patient needs an expensive diagnostic imaging procedure, but they also know that patient lacks health insurance, or has an inadequate plan? How do they weigh financial considerations against crucial diagnostic information?


As physicians, you balance a huge number of variables in deciding which diagnostic imaging procedures to order for your patients. You must weigh radiation exposure versus probability of actionable images, for instance, or decide whether a patient needs an X-ray, an MRI, or both.


And like it or not, every decision a referring physician makes will have an impact on the patient’s final bill — which becomes problematic, both ethically and medically, given the role financial stress plays in negative health outcomes such as depression.


Lack of Health Insurance and Frequency of Diagnostic Imaging


Here’s what we do know, at least as of the 2012 publication of this study from the Journal of the American College of Radiology: Uninsured Americans received fewer imaging procedures in emergency departments than insured patients. In a sense, this is unsurprising; Americans without health insurance generally receive less health care overall.


What we don’t know is what to do about it. Should we order less imaging for insured patients, or more for uninsured patients? We won’t really know until we can measure the outcomes of uninsured patients who receive equal care. To do that, we must find a way to provide truly affordable diagnostic imaging for all patients. That’s where Precise Imaging can help.  


How Physicians Can Reduce the Financial Impact of Imaging on Patients


The ideal situation would be for physicians to have access to imaging centers that offer a full and flexible range of payment options along with the highest-quality service, simple scheduling, and fast results. That’s exactly the combination that Precise Imaging offers to referring physicians.


Precise Imaging operates 70+ locations with evening and weekend hours, so your patients can always find a time and a place that suits them. If transportation is a problem, Precise Imaging can send a car for free. And with same-day scheduling and a 24-hour average turnaround on reports, you’ll have the information you need without delay.


But the real issue for uninsured patients is the financial burden. That’s why Precise Imaging’s experienced billing team is trained and authorized to handle an incredible variety of payment options. For personal injury cases, they can accept liens. If workers’ compensation is involved, that’s no problem.


Precise Imaging even offers special cash prices for uninsured or underinsured patients. Friendly billing staff can also work with payors to establish structured payment plans. These options can create powerful discounts for patients in need, and might be just the assurance that you need to order a procedure you’re on the fence about.


Financial considerations shouldn’t have any place in patient care, but, unfortunately, they are real, and must be considered. Next time you’re weighing the options for an uninsured patient, remember that Precise Imaging can help. Call Precise Imaging at 800-558-2223 to learn more about cash prices for uninsured patients.    




Moser, James and Kimberly Applegate. “Imaging and Insurance: Do the Uninsured Get Less Imaging in Emergency Departments?JACR. Journal of the American College of Radiology, Jan. 2012. Web. 29 Sept. 2017.


Galea, Sandro et. al. “Urban Neighborhood Poverty and the Incidence of Depression in a Population-Based Cohort Study.” ScienceDirect. Annals of Epidemiology, Mar. 2007. Web. 29 Sept. 2017.


Personal Injury Attorneys and Diagnostic Imaging: A Patient-Centered Approach

Personal injury cases often hinge on great diagnostic imaging, and attorneys can benefit from referring their patients to a provider with experience in the field. While injured patients are free to schedule an MRI or X-ray at a hospital or random imaging center, cases flow much more smoothly when attorneys and their clients choose providers that know how to best assist in the case, while providing excellent, patient-centered care. Here are a few reasons personal injury attorneys should stick to a single preferred provider for diagnostic imaging:


Patients might need to pay for diagnostic imaging with a personal injury lien.


Many medical providers aren’t equipped to handle lien payments. When attorneys and clients agree on an imaging provider prior to injury, they can choose a company that has long years of experience handling personal injury cases, including lien payments — that is, a company like Precise Imaging.


Attorneys often need diagnostic imaging results quickly.


Hospitals sometimes experience lengthy delays before they can schedule a diagnostic imaging procedure. Then, when the procedure is complete, staff radiologists might take days to complete the radiology report. Meanwhile, case deadlines can come and go.


Precise Imaging offers same-day scheduling and quick turnaround times for reports. Radiologists file their reports within 48 hours of the procedure, and usually much sooner, often within just 24 hours.

Not all imaging centers are prepared for letters of protection.


For personal injury cases involving a letter of protection, it’s important to choose an imaging provider that has experience with this legal tool. Precise Imaging has partnered with patients and their attorneys for thousands of personal injury cases, and accepts every type of remuneration, including workers’ compensation, liens, and deferred payment based on a letter of protection.    


Attorneys can simplify client care with a preferred diagnostic imaging provider.


With Precise Imaging for personal injury cases, a single phone call gives attorneys everything they need to win in court. In fact, attorneys never need to pick up the phone to get help for their clients. A specialized attorney web portal provides images, payment information, and case details with full HIPAA compliance. It’s available 24/7, and so is the IT support that ensures everything runs smoothly.


Clients will appreciate the friendly, professional service they receive at any of Precise Imaging’s 70+ locations. They’ll also love the simple scheduling, with evening and weekend appointments available. Attorneys, on the other hand, will find a streamlined approach that simplifies personal injury cases while providing medical details that win in court.


To learn more about Precise Imaging’s commitment to assisting in personal injury cases, or to refer a client today, call 800.558.2223. You can also make an online referral here.

Online Portal

Why Online Radiology Portals are Good for Physicians and Their Patients

Online radiology portals are slowly moving into the mainstream. The advantages of these information-sharing platforms are clear. Physician portals allow quick, simple referrals and real-time access to diagnostic images, plus immediate interaction for remote members of health care teams. Patient portals give recipients of diagnostic imaging procedures unprecedented information, control over their own health care decisions, and more direct interaction with radiologists.


But are online health portals really working for patients and their physicians? What does the science say about the benefits and/or drawbacks of these tools? A recent surge of studies gives us some idea. Here are a few takeaways from the latest research on radiology portals:


  • An early study, published in the Journal of the American College of Radiology in 2015, concluded that “Referring-physician release of radiology reports via the online portal is important to patients, useful to referring physicians, and does not affect referring-physician workloads.” However, the study noted, physicians may wish to delay the release of the radiology reports until after they’ve had the chance to discuss the findings with the patient.


  • A more recent study from the American Journal Of Roentgenology suggests that online patient portals create more communication between radiologists and patients themselves. This could be a profound shift; traditionally, radiologists confer with physicians, who then speak face-to-face with patients. Through the use of online radiology portals, patients may benefit from more direct interaction with their radiologists. “Radiologist collaboration with referring physicians is important in providing care in accordance with patient preferences,” the study cautions.


  • A 2016 article from the Journal of the American College of Radiology picks up this theme of the changing role of the radiologist in an era of online portals. When patients have direct access to radiology reports, they’ll likely have questions and/or concerns.


“Ultimately, radiologists may have to stop thinking about the radiology report as their final product and, instead, start thinking about the report as a springboard for becoming more active health care partners,” concludes Christoph Lee et. al., authors of Implications of Direct Patient Online Access to Radiology Reports Through Patient Web Portals.


These changes provide benefits to patients and referring physicians alike, the authors suggest: “The published evidence to date suggests that the potential benefits likely outweigh the risks of providing patients with direct online access to their medical records, including their radiology reports.”


Online Radiology Portals for Physicians and Patients at Precise Imaging


Every Precise Imaging location offers physicians access to a robust online portal. There, doctors can make quick referrals, receive radiology reports, and interact with the radiologists who write those reports. We offer 24/7 IT support and simplified payment modalities.


Meanwhile, patients can track their own health care journey through our fully HIPAA-compliant patient web portal. With these digital tools from Precise Imaging, patients, physicians, and radiologists all remain on the same page, striving for better outcomes.


Learn more about Precise Imaging’s online portals by calling 800-558-2223 today.




Gefen, Ron, Michael bruno, and Hani Abujudeh. “Online Portals: Gateway to Patient-Centered Radiology.” AJROnline. American Journal of Roentgenology, July 2017. Web. 18 Sept. 2017.   


Henshaw, D., et. al. “Access to Radiology Reports via an Online Patient Portal: Experiences of Referring Physicians and Patients.PubMed. Journal of the American College of Radiology, June 2015. Web. 18 Sept. 2017.


Lee, Christoph, et. al. “Implications of Direct Patient Online Access to Radiology Reports Through Patient Web Portals.JACR. Journal of the American College of Radiology, Dec. 2016. PDF. 18 Sept. 2017.


How Hospitals Determine the Price of an MRI—and Why Clinics Can Charge Less

How Hospitals Determine the Price of an MRI—and Why Clinics Can Charge Less


When your doctor orders an MRI, should you stay within the hospital system or find an independant imaging center?


If you want to pay less, you’re better off with the latter.


You’d expect a similar procedure to have a similar cost, no matter who your provider is. In fact, the price of an MRI might vary wildly, even within the same small region — and even when funded by the same insurance plan. For instance, a 2014 report from medical-claim analysts at Change Healthcare found that the insurer’s in-network price for an MRI ranged between $511 and $2,815.


Not much has changed since 2014. The latest figures from financial-planning site Bankrate report a general range of MRI costs between $400 and $3,500. That’s a $3,100 spread for the exact same procedure.


“Imaging bills typically run two to three times higher at hospitals than at freestanding radiology centers,” reports Money. But what’s the rationale for this tremendous difference in price, especially since clinics often use the exact same equipment and radiologists as hospitals?   


To find out, we’ll have to go a little deeper into the complex world of health care pricing for hospitals.


Calculating Prices for MRI Scans at Full-Service Hospitals: DRG Basics


While hospitals follow different pricing schedules, every operation works to ensure profitability of these things called diagnosis-related groups, or DRGs.


DRGs are specific codes covering treatment for common conditions. That is, they gather all the discrete medical interventions for a particular diagnosis into a single, calculable “product.” They’re important for hospital balance sheets because Medicare decides what it will pay for care according to each of these codes — and hospitals can mark up their prices from there.


For instance, if you were to have an appendectomy, the hospital might add the costs for your imaging, surgery, aftercare, and drug/equipment usage into a single cost under the assigned DRG code. If you were on Medicare, there would already be a pre-set price for the entire set of procedures. If an insurance company pays for the services, though — or an individual — hospitals determine their own rates for those DRGs. That’s where things get even more complicated.

Estimating Radiology Department Costs in Order to Set Charges

The typical model that hospitals have used to figure out how much to charge for a given DRG service is called the ratio of cost-to-charge (RCC). The RCC figure divides the hospital’s total costs by the amount they charge the payer. The resulting ratio describes the hospital’s ability to turn a profit. The lower the RCC, the more profit for the hospital.


So, the RCC approach became the standard method used to figure out how much to charge patients. The problem is, while RCC calculations are very accurate and reliable for grouped charges, such as DRGs, they’re notoriously off-base when it comes to individual services, such as those offered by radiology departments.


Forward-thinking hospitals slowly began to change their methods of determining charges, a process that inevitably begins with figuring out total costs per procedure. Here’s an example of another approach, provided by David W. Young in the journal Healthcare Financial Management:


Young divides costs hospitals must pay for an MRI scan into three categories:


  1. Direct costs include the obvious hospital expenses; salaries for staff, medical supplies, and depreciation of machinery.


  1. Departmental costs cover the salaries of administrators.


  1. Allocated costs flow down from the hospital administration; they’re comprised of the estimated value of maintenance and janitorial services for the radiology department.


Once administrators figure out these costs for an MRI scan, they add them together, then divide by the number of MRI scans in a given period; this gives them a total estimated cost for the procedure on its own.


Of course, if that cost should prove higher than Medicare, they will still only be paid the official price set by the Centers for Medicare and Medicaid Services (CMM). That’s one of the reasons some hospitals mark up their Medicare prices by up to 1,000 percent for insurance companies or cash payers; they argue they’re making up for expenses left uncovered by government programs.  


MRI Scans: Determining Individual Charges from Cost Estimates


Once administrators calculate the cost of an MRI, all that’s left is to apply the markup and start issuing bills. So what determines a hospital’s markup over cost on an MRI, or any service for that matter?


Just about anything. Possibly nothing. It’s the mystery at the heart of the U.S. health care system. Only two states, Maryland and West Virginia, set top rates for hospitals. Everywhere else, health care providers can charge whatever they want—and they do.


A 2015 study in the journal Health Affairs studied markups at U.S. hospitals. The average markup among most hospitals in the nation was 340 percent. Among the 50 hospitals with the highest markups, that number was over 1,000 percent. The hospital at the top of the list marked up procedures 1,260 times the CMM charge.


Radiology departments are particularly vulnerable to enormous markups. Brian Keigley, who founded the consumer group New Choice Health, told Money that “radiology is often subsidizing other service lines.”


For instance, if an emergency department at a major metropolitan hospital loses money, administrators might raise the price on MRIs to make up the difference. This brings us to why freestanding imaging facilities can charge so much less per procedure.  


Keeping Costs Low at Medical Imaging Clinics


Hospitals can mark up their costs for an MRI as much as they want. There are no regulations to control medical pricing in most states, and being part of a hospital system keeps patients flowing regularly through the radiology department.


Ultimately, hospitals are sheltered from price-controlling market forces by obscure charges, patient vulnerability, intra-institutional referrals, and, often, non-profit status.  


Meanwhile, freestanding imaging clinics must compete with the facility down the street. There’s a distinct incentive for Company A to offer low-price MRIs without sacrificing quality. Remember: They’re also competing with hospitals, which usually get the first shot at any patient’s business.


Plus, imaging clinics don’t have to cover for underperforming departments. They provide MRIs and X-rays; their radiologists write reports; they do what they do and that’s it. With a more focused business model, these companies are much more free to reduce margins in order to thrive through sheer patient volume.


The result is good for patients and their care. Clinics offer simpler, more flexible scheduling. They can focus on patient care rather than cope with the complexities of an enormous organization. They charge much, much less than hospitals for an MRI.


In short, it pays to do a little shopping around when your doctor orders an MRI. Whatever you do, don’t march down the hall to the hospital radiology department without having a conversation about pricing.  




Ashford, Kate. “What I Learned When I Asked How Much My MRI Would Cost.Forbes. Forbes Media LLC, 31 Oct. 2014. Web. 1 July 2017.   

Deleon, Maya. “Need an MRI? Here’s what it will cost.Bankrate. Bankrate, LLC, 23 June 2017. Web. 1 July 2017.


Gengler, Amanda. “How to Get the Same Health Care at a Quarter of the Cost.Money. Time, Inc., 16 July 2014. Web. 1 July 2017.


Glover, Lacie. “Why Does an MRI Cost So Darn Much?Money. Time, Inc., 16 July 2014. Web. 1 July 2017.  

Potter, Wendell. “Why Hospitals Mark Up Prices by 1,000 Percent.Newsweek. Newsweek, LLC, 15 June 2015. Web. 1 July 2017.     

Reinhardt, Uwe. “How Do Hospitals Get Paid? A Primer.NYTimes. The New York Times Company, 23 Jan 2009. Web. 1 July 2017.


Schwartz, M, DW Young and R Siegrist. “The ratio of costs to charges: how good a basis for estimating costs?NCBI. U.S. National Library of Medicine, 1996. Web. 1 July 2017.


Young, David W. “What Does an MRI Scan Cost?” Healthcare Financial Management, no. 11, 2015, p. 46. EBSCOhost, 1 July 2017.


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