Statement regarding Preventive Care and Office Visits.
You may be wondering why we bill a preventative office
visit concurrently with an “evaluation and management”
service. The reason being is that we provide both
Insurance companies recognize that we provide both services
and that they should pay for each separately and
distinctly. We bill appropriately to expedite proper
claims handling by your insurance company.
Please be advised that our contracts with insurance
companies are very detailed, especially in regard to these
provisions. The insurance companies, however, do not
always share forthright these coverage allowances. Please
realize that all of our fees are essentially set by
Over the past several years there has been a trend for
health insurance carriers to raise the level of deductibles
with contract renewals. Many health insurance companies
advertise that “wellness care” or “preventative”
examinations are covered at 100%, without having to meet a
deductible. To the contrary” “evaluation and management”
services (dealing with your symptoms or health issues) get
applied to your deductible and thus, an out-of-pocket
expense for you.
So for patients who have symptoms, known medical problems
that are requiring attention, or medications that require
refills, it is not reasonable to expect this to fall under
your “wellness” or “preventative” care. This care
is separate and distinct from the “wellness” or “preventative” care
and will be charged as such. We expect you to be aware that you
may have out-of-pocket expenses for this care. We will continue
to bill for these services as appropriate. Please be aware that we do
strive to provide the best care for you and do encourage a
periodic preventative or wellness exam.
Medical Specialists Associated Physicians