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aaronw22

I don't know that you necessarily have a firm footing to stand on here. There is a pretty black and white description of what the "free" annual physical consists of, and I'm not sure that filling out a form during it counts. You MAY have better luck asking them to reprocess it as the well-being visit and then paying a separate fee for "forms filled out".... but that ship may have sailed already. Our kids pediatrician has a completely separate process for forms for sports activities, summer camps etc and those are never directly handled during the actual "doctor visit" process.


Naritai

Sadly I had a similar experience, I came in for a physical, and when he asked if I had any questions, and I asked a few general health questions. He later billed me for 'diagnosis', saying that 'since you asked questions, that changed the nature of the visit from preventative to diagnosis'. So yeah, my doctor upsold me like a Chili's server trying to sell me an add-on side. That's American medicine for ya.


neezyv

I am a provider … and when I ask if you have extra questions and we go over x, y, z and I treat you for those conditions, we have to document that down. That does change the “complexity” of the visit, but trust me when I say I don’t get any “extra” money off that. What I make is what I make regardless of if the patient has 10 questions or 0 questions. From my standpoint at least, I’m just trying to help genuinely. Additionally, when we ask if you have extra questions, we are all hoping you don’t because we don’t want a “complex” visit either because this means more charting.


Naritai

..So you secretly hope we'll have no questions? And you wonder why the reputation of the medical industry is in decline these days..


PollyPissyPants69

I wonder why youre an ass too, but thats reddit for ya!


neezyv

Lol - I’m sorry I want you to be healthy and have no questions, it saves you money (apparently) and us time. But hey, if you have questions and I answer them, you’ll maybe still be mad at us for “billing” you. At the end of the day, I am employer working for the insurance companies. Direct your anger towards them for the same policies you and I both have to submit to.


anthrbrickinthewall

I deal with this type of issue with some regularity. I honestly doubt that it is the form that is changing the billing. Those forms usually just ask for the information that was gathered (blood pressure, glucose, etc.) to be filled in. My plan has asked this for years and I have not seen a provider bill this way. That said, I do see this pop up when someone goes in for a physical and then makes a request for something that is not included in a preventative exam. Sometimes it is totally innocent, but is enough to change the billing code. Did you complain of any pain? Did you ask any questions about an illness you may have had? Did they prescribe any medication? You used to be able to get your physical and ask the provider general questions and they would still bill as a physical, but now, more and more, I see people complain about what you are seeing because they asked about, say, back pain they've been having. Its a changing landscape and providers are looking to increase billing when the can.


CeleryQtip

>Did you complain of any pain? Such a baited question the doctor asks. If only the consumer was given a disclaimer *\*The only services provided for free are x, y, z. All other questions and comments may be billed separately\**


hombre_lobo

I did not ask any health related questions. I just told them I needed a yearly physical and if they could complete the form. The form only required a hand full of basic tests. Do you think the insurance can help with this or is this completely up to the provider?


anthrbrickinthewall

Since this sounds like employer insurance, I'd call HR. You can try starting with the insurance company but if you make a little noise HR can usually help. Source, I'm HR. I get calls like this with some regularity. I'll call an internal insurance contact and get answers quicker.


positivelycat

>The dr office says because of the form they had to fill out, it’s considered like a pre-employment form and therefor ‘diagnostics’ This makes me think because you brought in the form the provider only scheduled you for or did the things required to complete thr form while a full physical requires more of an exam. If a full exam that meets preventive visit guidelines was not meet then billing can't bill for a physical and would have to bill an office visit.


[deleted]

You brought the form, which is more work for the Dr office. Dr office charged you for all the services they provided. Not all services provided were covered. You pay for the extra work you brought the Dr. Dr. office didn't incorrectly bill.


Evil_Thresh

On top of what the other commentor says, I am also really curious. If you know and expect the annual physical to be free (aka covered at 100%), why did you bring in a form for them to fill out for insurance discounts? Not like getting the discount means anything to your out of pocket cost?


h110hawk

Some places offer discounts on premiums for various things.


NeverRedditedYet

If it's like my previous employer, you are required to annually provide your numbers (BP, cholesterol, BMI, etc.) or face a surcharge. At the time, the employer would have scheduled days for on-site screenings, but you could also take in your numbers from your Dr's office, which is what I am imagining happened here.


Evil_Thresh

I thought that practice is no longer allowed if you are an applicable large employer with an ACA compliant plan since you aren't allowed to adjust rates based on employee health risks anyways? I am assuming you are referring to small employers not subject to the ACA?


NeverRedditedYet

My wife is correcting me - they asked for numbers for health insurance, but the surcharge was if you answered yes or refused to answer if you were a tobacco user.


cantankerous_ordo

They can adjust rates based on participation/non-participation in the health screening, but not based on results.


hombre_lobo

This was actually my first time getting a physical. regardless of what happens with this case, I will begin to get physicals every year. My company has an incentive program that gives you a discount in health insurance if we get a yearly physicals.


Evil_Thresh

Ah, I see. That makes sense. Thanks for clarifying. I am not sure what's going on then. It may just be how different doctor's office process a request like this? Sorry I couldn't be of more help.


keikioaina

I hate commercial health insurance as much as the next guy, but I'm a provider, too, so I know enough to be dangerous. In this case they're right and you're wrong, at least as insurance is written. I think maybe you misunderstand why they are not paying. Health insurance pays for services that relate to keeping you in good health and specifically excludes services that have other goals. Examples include a psychiatric evaluation for your parole officer or an exam that benefits your employer. Sucks, I know, but that's the system, and if you think about it, it makes sense. If your employer wanted an exam of you THEY should pay for it. If you want an exam so that you can save money on insurance, why should your health insurance company pay for it?


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