Statement regarding Preventive Care and Office Visits.

Dear Patient,

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

services.

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

contract.

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.

Sincerely,

Medical Specialists Associated Physicians

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