All Visit Types
On occasion, a patient may come in for a sick visit and may ask for or agree to a general physical or wellness exam. In those cases, the physician will provide both services, reviewing the patients specific health problems, but also performing an overall wellness check. When this occurs, the doctor will mark both a sick visit and a physical on the charge ticket. Both services will be filed with the patients insurance and we will coordinate the balance due between the two charges, since the doctor already did a portion of the physical when evaluating the patient for their illness, and vice versa. For example, if insurance covers the illness part of the visit, we will subtract that payment from the amount owed for the general physical examination, so that the patient never has to pay for both services in full.
If the physician orders any laboratory tests, it is important for the patient to understand that any screening tests, done for wellness purposes, will likely fall under whatever physical benefits for which he or she has (or does not have) coverage. If the patient does not have wellness coverage, the patient will be responsible for any lab tests ordered for screening, or wellness, purposes.
We understand that this is confusing, but we are required by Medicare and by our various insurance contracts to accurately report the services that we render, so that they only pay for what they are financially obligated to do so. Our documentation supports the services that we render to our patients, so we will not be able to go back later and amend that documentation to help a patient get better reimbursement from their insurance company.
Remember that your insurance coverage is your responsibility. There are literally thousands of types of coverage out there, and we are unable to keep track of all of them. It is important that you be familiar with your benefits and coverage, whether provided by your employer, by Medicare or by your own private plan. Our business office will assist you in any way they can by answering your questions or working out payment arrangements if you have a balance due on your account.