Business Office, Insurance and Records
What insurance plans does RAPA accept?
How can I pay my bill?
We will be happy to bill your insurance company directly if you provide the correct billing information at the time of service. When you arrive at RAPA, we may ask to see your insurance identification card or ask additional questions about coverage. If you are covered by more than one insurance plan, please provide all appropriate information when you register. It is your responsibility to verify insurance coverage and benefits prior to obtaining services. In some cases, prior authorization is needed for testing. Please contact your insurance company and review any documentation they have provided you to assist with questions you have regarding your specific insurance coverage.
Computed Tomography (CT)
Why do I need to drink the (oral contrast) barium and have an injection (Intravenous Contrast) for the CT scan?
Not all CT scans require oral and IV contrast. When it is required, the reasoning has to do with the structures of interest. Oral contrast allows the doctor (radiologist) to better visualize the bowel as separate from other structures present in the abdomen. This is very important when the complaints have to do with bowel related problems or if the abdominal complaints are non-specific, such as general pain or discomfort. The IV contrast agent is very helpful in evaluation of the solid organs (liver, spleen, pancreas, adrenal glands and kidneys). The radiologist looks to see how the organs respond to the contrast agents and are able to make accurate determinations of normal and abnormal enhancement patterns. These patterns of enhancement can reveal disease processes that cannot otherwise be detected. When abnormal masses are present, the radiologist can many times determine if the mass in benign (not cancer) or more worrisome for a cancer-like condition. Benign masses can be left alone or evaluated over time to show that they don’t change. The more worrisome enhancement patterns seen in some lesions (tumors) will often need to be biopsied.
Are there side effects to drinking the barium?
Any time that a substance is ingested, including some foods, there is a possibility that the substance will be disagreeable to the GI tract. This is no different when drinking the barium contrast. Most of the time, there is no side effect. Some people will experience nausea, some will experience nausea and diarrhea.
How long does it take to “flush the system” of the oral contrast (barium)?
Any ingested liquid takes about 1 1/2 hours to pass from the stomach to the colon. Once the barium reaches the colon, times can vary, depending on the individual. in some cases, the barium is evacuated within a few hours, in most cases by the end of the day. Occasionally, it may persist in the bowel for 2 or three days. Generally, the patient has a good understanding of how their GI tract reacts to ingested substances, and for the oral contrast, it should be no different.
The intravenous contrast in generally eliminated from the system within one or two hours by the kidneys. In some individuals, some of the contrast is eliminated by the liver, excreted into the bile.
Standard Colonoscopy vs.Virtual Colonoscopy
A standard colonoscopy requires about 45 minutes for the procedure and up to an hour for recovery. Typically a sedative is given, so the patient must have someone drive them home, and the patient likely will miss an entire day of work.
Virtual colonography is a test with about 5 minutes of discomfort and a half hour of recovery. The patient could return to work after the test.
Virtual colonoscopy can also detect abnormalities located outside of the colon in which traditional colonoscopy cannot image.
What are the advantages of a Virtual Colonoscopy?
A virtual colonoscopy is less invasive than traditional colonoscopy. There is decreased risk of perforating the colon. Virtual colonoscopy has ability to show abnormalities outside the colon, which would otherwise be missed. In addition, there is no sedation and the result provides clearer, more detailed images than a conventional Barium Enema x-ray examination. This is ideal for patients with an increased risk of complications or elderly patients who cannot tolerate a colonoscopy. It is also helpful when a standard colonoscopy cannot be completed when the bowel is too narrow or obstructed.
Does Insurance and Medicare cover this procedure?
Virtual Colonoscopy as a screening method is not currently covered by Medicare. However, some private insurance companies are covering this exam for patients with failed or incomplete traditional Colonoscopies. It is recommended that you contact your insurance carrier to verify this coverage.
Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA)
Does MRI use any type of radiation to produce the picture?
MRI produces precise images of the body’s internal organs without the use of x-rays and radiation. MRI generates high-resolution images that appear as a slice of the body’s anatomy. The images are produced using a large magnet, radio frequencies and a computer. The computer processes these signals to produce highly detailed images of your anatomy. MRI is also capable of producing these images in an infinite number of projections throughout the body. These images are useful in the early discovery and treatment of many conditions and diseases.
What is MRA?
Magnetic Resonance Angiography (MRA) uses the MRI scanner to image blood vessels of any body part, most commonly those in the head, neck, abdomen and lower extremities. Unlike conventional angiography, MRA does not require an intra-arterial injection with x-ray and radiation.
What happens during the MRI exam?
At Radiology Associates a registered technologist will position you on a padded scanner bed, which is very similar to an examination table. The technologist will properly position the part of your body to be scanned and make sure you are relaxed and comfortable. For some studies, our technologist will provide you with music if you’d like. You will then be moved into the scanner. As the equipment scans you will hear noises from the magnet, which are peculiar but very normal. You will not see very much. You may feel a slight vibration or warmth (some patients fall asleep during their MRI scan). All that is required of you is to be as still as possible during the exam. Based on the type of MRI you are having and the number of images required, each series of scans will last 20-45 minutes.
What should I wear for my MRI exam?
Wear something comfortable. There are some exams such as spine, breast and abdominal studies that will require you to change into a gown. Because of the magnetic field,we also ask that you not wear any metal hair clips which can interfere with your scan. A secure locker will be available to leave coins, jewelry,watches, eyeglasses, credit cards, keys, hairpins, and other metal objects in a safe place.
Is open MRI better than a regular MRI?
While patients may find the open MRI scanners easier to tolerate, some machines use a lower field magnet which generates lower image quality or have longer scan time.
Why do I need to have a full bladder?
It is necessary to have a full “bladder” (where the urine is stored) before the procedure. That means you will need to drink a lot of water before you arrive for the test-usually about 32 ounces or 4 tall glasses.The reasoning has to do with the way sound (including ultrasound) is carried through the different structures (tissues such as the bladder) of the body. When sound passes through soft tissue, it looses energy. When it passes through water (urine in a distended bladder) the energy of the sound is conserved. Because the soft tissues in the pelvis are deep in the pelvic cavity, a distended bladder gives a better chance that we will see the structures well.
Why do I sometimes need to have and endovaginal probe exam when I just had an exam transabdominal (through the belly wall or through the bladder)?
At times, particularly when there is an abnormality seen on the initial look into the pelvis, a transvaginal exam is needed to better visualize the abnormality. By looking more closely, through the use of the endovaginal probe, the radiologist can determine if the abnormality is of no real consequence ( a benign cyst) or needs further assessment. The endovaginal probe a better tool for looking at structures in close proximity to the vaginal walls. It is also useful when evaluating a first trimester pregnancy because the baby is so small and the heart flutters are so difficult to see otherwise.The tests are not painful but you may feel a little discomfort since your bladder will be full until you pass urine after the test. In the case of the vaginal probe, sensitivity depends on the individual. If the test is painful, let the technologist know. There may be some discomfort, but true pain should be reported to the technologist. It can be an indicator that an infection or ectopic gestation is a concern. This is an important indicator and should be reported to the radiologist.
X-ray and Fluoroscopy
Who will perform my exam?
A Registered Radiologic Technologist with special training in X-ray procedures and equipment will perform your exam. In many cases, one of the RAPA Radiologists will perform the exam. All exams are interpreted by a radiologist.
How do I receive my exam results?
After interpretation by the radiologist, exam results are quickly forwarded to the physician who ordered your exam. Though patients do not receive results directly from the technologist who performs the exam, a RAPA Radiologist or technologist will be happy to answer questions about the procedure.
Bone Density Scan / Osteoporosis Testing
Is there a special prep for the bone density exam?
No. You should wear loose, comfortable clothing, avoiding garments that have zippers, belts or buttons made of metal. Objects such as keys or wallets that would be in the area being scanned should be removed.
Can some medications interfere with the exam?
Yes. Some medications such as calcium supplements and antacids such as Pepto-Bismol may interfere with the result because they contain heavy metals that may absorb or block the energy of the x-ray and falsely elevate the test result.Also, inform the technologist or scheduler if you recently had a barium examination or have been injected with a contrast material for a computed tomography (CT) scan or radioisotope scan. You may have to wait a few days before undergoing a DXA test.If you have metal in your back or hip, another site such as the wrist or heel may need to be evaluated because the metal would interfere with the test result, as well.
A Word About Minimizing Radiation Exposure
We take special care during x-ray examinations to use the lowest radiation dose possible while producing the best images for the test your doctor has requested. National and international radiology protection guidelines are reviewed and updated regularly so that the technique standards used by radiology professionals are in acceptable limits of exposure.State-of-the-art x-ray devices generate tightly controlled x-ray beams with specialized filtration and dose control methods to minimize stray or scatter radiation. This ensures that those parts of a patient’s body not being imaged receive a minimum scatter dose of radiation.Some facilities use out dated, sub-standard x-ray generators that expose patients to higher doses of radiation than are necessary to complete the test requested. Be sure the facility you choose for your exam uses equipment that is up to date with current standards and regularly checks their equipment for proper function. For more about x-rays and radiation safety, visit the following site: Radiation exposure: why does it matter?