SmartChoice high-tech radiology program offers savings to our members*

On April 1, 2014, Fallon Health introduced the SmartChoice program administered by eviCore healthcare, our partner for high-tech radiology screening services. SmartChoice is a program for MRIs and CT scans only which offers you savings by suggesting lower cost, and often more convenient, MRI and CT facilities.

How it works

If there is an MRI or CT imaging facility in your area that offers the same services as your doctor orders, but at a lower cost, the SmartChoice program alerts you to that option. As part of the program, they can even book an appointment for you at the lower cost facility.  Many of our members today are on plans with a deductible. By offering lower cost and often more convenient locations for MRI and CT imaging services, you can save on your out-of-pocket costs for these services. Also, since this is a voluntary program, you still have the choice to go where you are most comfortable receiving care.

Frequently asked questions

What is SmartChoice?

SmartChoice is a program from eviCore healthcare, our partner in radiology services utilization management. SmartChoice empowers members in how they spend their health care dollars and where they have imaging services performed. If there is an imaging facility in your area that offers the same services as your doctor orders, but at a lower cost, the SmartChoice program alerts you to this option. As part of the program, they can even book an appointment for you at the lower cost facility.

Who is eviCore healthcare?

Fallon partners with eviCore healthcare to manage high-tech imaging and radiology services. This partnership is designed to ensure that Fallon members receive the most appropriate and accurate diagnostic studies and to protect our members from the high cost and health risks associated with unnecessary utilization.

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What is the benefit of the SmartChoice program?

SmartChoice helps to drive down the cost of health care for members. Many of our members today are on plans with a deductible. By offering lower cost and often more convenient locations for MRI and CT imaging services, members save on their out-of-pocket costs for these services.

Also, since this is a voluntary program, members still have the choice in where they are most comfortable receiving their care. SmartChoice may also enhance the members experience by helping with scheduling appointments at the lower cost facility.

How are SmartChoice providers determined?

SmartChoice providers are identified by their lower contracted rates with Fallon. If there is an imaging facility in your area that offers the same services as your doctor orders, but at a lower cost, the SmartChoice program alerts you to this option. As part of the program, they can even book an appointment for you at the lower cost facility.

Why should I go to a different place than my doctor wants me to go?

The choice is yours. We want to let you know of options for other facilities that you can go to for your imaging services that are at a lower cost. If you choose to go to one of these lower cost facilities, the SmartChoice program can help you with scheduling and will notify your doctor.

How will my doctor get my scan information?

Results of the scan will be sent to your doctor. You can ask the facility to provide a copy of the imaging as well.

If the facility is lower cost, is the quality lower too?

All of our facilities are contracted, participating Fallon providers who are fully licensed and held to the same standards.

What is the cost difference between the facilities?

The cost for high-tech radiology services varies greatly and ranges from a few hundred dollars to a few thousand. This is why the SmartChoice program is an important tool for helping to guide our members.

How do I opt out of future phone calls from SmartChoice?

You can inform Fallon or a SmartChoice representative that you would like to opt out of the program. By opting out, you will not receive any future contact from the SmartChoice program.

Does the SmartChoice program delay the authorization process in any way?

The SmartChoice process does take some extra time, but all SmartChoice cases are completed within the standard time requirements in place today for Fallon.  

* This program applies to all Commercial members except for Steward Community Care members and members with a Reliant Medical Group PCP.