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By Leah Mararo | July 28, 2016 | Uncategorized

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Health care is moving in a more consumer-focused direction. This means you’ll have a greater role in determining the kind of health care you want – and what you’ll spend on it.

Your doctor says that you need an MRI, CT scan, or another procedure. Sometimes it’s not always crystal clear why you need it, and there may be some confusion on what the next steps should be. Should you do exactly as the doctor says or get a second opinion? You know you should ask questions, but which ones do you ask?  Do you call your insurance company? And if so, what should you say?

Even when time is of the essence, there are some things that you should always do to ensure the best outcome for you and your family.


“Patients should never be uncertain about the doctor’s plans for them,” said Blue Cross and Blue Shield of North Carolina’s Executive Medical Director John Fong. “Any question you have in your mind, make sure you ask it out loud.”

Regardless of the procedure that the doctor is recommending, it’s always useful to ask questions to better understand what the procedure or test involves and why your doctor wants it done. This will also boost your confidence that you are making an informed decision. Here is a simple infographic highlighting some of the questions you should ask:



In some cases, it may be necessary to start treatment as soon as possible and you may not have time to get a second opinion. But whenever possible, a second opinion is a good idea. According to an article in the Washington Post by Consumer Reports, some tests are done more often than they should and not always in the best interest of the patient.

You should be completely informed about all your options. Bear in mind that the first and second opinion may differ and this is yet another reason you should see another provider. If the opinions are the same, it will put your mind at ease that you are making the best decision. If you feel it’s necessary to bring a family member or a friend with you to the doctor’s office, do so. They can ask questions you may not have thought to ask, and they can also keep track of the information if you are too ill or distressed to manage.


Not all doctors or hospitals are the same. There is a host of choices on where to get your procedure done. Prices and quality of care vary widely even within the same city. Our cost estimator tool can tell approximately how much the procedure will cost you. Depending on what you are having done, Blue Distinction® Centers or providers can give you a high level of care at a lower price. These centers and providers are recognized for their outstanding quality of care, service, and patient safety. Blue Distinction Centers and Blue Distinction Centers+ deliver expert skill in quality care, treatment, and overall results.  Blue Distinction Centers+ provide a high level of specialty care at lower cost.

You can find a doctor, dentist, or facility without even logging into your account.  You can also call us and we will find an in-network provider for you. Some procedures require prior plan approval from Blue Cross and Blue Shield of North Carolina. Ask your doctor for the procedure code and call customer service (use the number on the back of your insurance card) to find out if approval is needed before you get the procedure done.

Tests are necessary to confirm what your doctor thinks and also to help your doctor give an accurate diagnosis. But remember, it is possible to over test and over treat. If a doctor recommends a test that you may not need, other than the monetary and psychological impact this has on you, misleading results often lead to more tests or treatments that carry risks.