Billing for an "office visit" with free preventative care - is this the new healthcare scam?

[Anonymous]

Anonymous wrote:Our primary care physician's office recently put up a sign warning that we might be charged if we bring up a different topic during a preventative care visit.

It seems like this is like a check up for a pet that can't talk.

[Anonymous]

Anonymous wrote:MD here. It’s a billing thing. Our emr pulls from our notes so if we document it- you’ll be charged. If you truly want a free visit - do not bring anything up and just focus on your general preventative stuff but honestly it’s so hard to get a doctor’s appointment, I’d just pay the bill. In my own life, I suck it up and pay my own pcp so I understand this also from a patient’s perspective, Also it’s a bit frustrating for people to blame the doctors for this, esp primary care doctors who don’t make much and we need more of. Talk to your legislators about free health care for all. Don’t blame someone for doing their job, billing appropriately for the work they’ve done and just trying to make a living after years of training and debt.

I do blame the doctor. They are with you less than 15 minutes. And I see the EOBs. You get a couple hundred for the well-visit, and then want another $150 or whatever for the SAME visit that fit into the SAME 15 minutes. Plus you do the labs in house so you are skimming profit off those too. So you think you should make $400+ per quarter hour?

This goes against any rational sense that an ounce of prevention is worth a pound of cure. You are going to make people skip preventative care and only see someone when there is an urgent issue. I still remember our doctors practically begging us to still come for physicals in the early days of covid because no one was going to doctors and they were hurting for revenue. Is that what you want to happen?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Our primary care physician's office recently put up a sign warning that we might be charged if we bring up a different topic during a preventative care visit.

It seems like this is like a check up for a pet that can't talk.

+1. I only get physicals now so they will give me the refills. If they are going to charge me for refills anyway, I'll stop doing the physicals and also start stock piling the medication so that I don't have to get a refill appt nearly as often.

[Anonymous]

Anonymous wrote:This has happened to me twice now. We go in for a physical which is fully covered by insurance and then end up receiving a bill for an "office visit" for $150+.

The first time it was for me and I was told it was because I "discussed a new issue" with my doctor. 1. - I didn't. He asked if I needed a refill for a condition I've had for 20+ years. I said yes. B. Even if I did bring up a minor issue, do they not want us to answer honestly when they ask us health questions or ask if we have any concerns? We should just say nope!

Then it happened again with my daughter at a completely different practice. The NP (because of course the ped doesn't do physicals) decided she wanted my daughter screened for a minor issue by a specialist. An issue that we did not ask about and were not concerned about. So she handed me a piece of paper with some pre-typed names on it. Turns out that writing "referred patient for X" is enough to get you billed for an "office visit." So then I took my daughter to said specialist (another $150+) for them to laugh and say my daughter definitely does not have X condition. And then I received the bill from the Ped's office for an "office visit" instead of the well visit.

In both cases, the conversation about the "issue" was less than 60 seconds and not initiated by me. After some back and forth and arguing I was able to get the charges removed. But both required persistence, multiple phone calls and talking to more than one person. Which I guess they are counting on a certain percentage of people not doing. In both cases they acted like they are doing me a favor rather than correcting their own error (best case scenario) or outright billing fraud (worst case scenario.)

So just, be very aware and vigilant for this, particularly if you are on a high deductible plan.

Yes, this is becoming very common. My GYN asked me about an issue during my annual and then billed for it.

Sadly, I think you have to go into the appointment and state you are there for preventive care and don’t authorize care or billing for additional issues. Just another day in healthcare in the greatest country in the world.

[Anonymous]

"How much are you going to charge me if I answer that question/fill out that form?"

[Anonymous]

Ugh, this has happened to me too and I agree that it feels like a money grab, which is off-putting considering the amount my insurance company is already paying for the physical.

[Anonymous]

Anonymous wrote:"How much are you going to charge me if I answer that question/fill out that form?"

22:17 poster. This is what I have started doing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:A free preventative care visit (or a “checkup”) is for the appropriate health screenings ONLY. If you have other concerns, you are likely going to pay your copay. It’s not new or a scam, except to the extent that the entire system is a scam.

It is both new and a scam. It was not happening before. If your doctor says “have you had any insomnia?” to you at your well visit, saying “yes, sometimes” shouldn’t cost $150. If they aren’t going to screen for potential issues, there is no point to the visits at all and we should stop doing them.

No, it is not new. This is what the Affordable Care Act mandates be covered for no copay. It is exactly analogous to your “screening” colonoscopy being covered in full while my “diagnostic” one (in which a polyp was removed) was not. And same for “screening” mammogram vs. the follow-ups required if there are findings.

They pay for what they are legally obligated to pay for and that is IT—often not even that. If you want more, vote and advocate for better. I’ll be with you.

[Anonymous]

Anonymous wrote:Our primary care physician's office recently put up a sign warning that we might be charged if we bring up a different topic during a preventative care visit.

Ours have done that for a long time, and that makes sense if you’re asking about something new and time consuming, but they shouldn’t be charging if they’re the one bringing up the issue.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:If the doctors in the practice are actually aware of this shadiness going on, then shame on them. It's one thing if it actually makes the visit take longer or they have to do extra work. 60 seconds of talking that you would have done anyway is just a scam.

Of course they know. Private equity bosses give doctors quotas.

Well not me. I'm now bringing it up at the beginning of every well visit and letting them know I do not wish to discuss anything that will trigger a bill. If enough people do this, it will stop. The entire point of ACA mandating free preventative health care is so that people will actually GET preventative health care. This nonsense is going to achieve the exact opposite of that. It took me forever to find a non-shady dentist too. I will go on another PCP quest if need be.

I did that with my GP. He still charged me. The only thing left to do is to take a recorder and record the whole visit. And then start suing these mofo. No lawyers who can help with this.

[Anonymous]

This is all terrible and deceptive because I feel like I HAVE to fill out any form they give me at the doctor. The power imbalance is real.

[Anonymous]

Thank you for the heads up! My provider does not do this. If I stray off the topic, she will say to book another appointment.

I can't imagine a business charging for a piece of paper with a referral on it. I'd consider finding a new practice.

In the past, a doctor wanted me to come into the office and have an appt for him to tell me I had low iron. When you have low iron like I did, you can barely walk. Later, I found out he wanted me to come in person so he could charge for a visit. He could have sent me a portal message or called me like other doctors have done. It's not like he was telling me I had incurable cancer, which would warrant an in-person conversation; it was just low iron.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This has happened to me twice now. We go in for a physical which is fully covered by insurance and then end up receiving a bill for an "office visit" for $150+.

The first time it was for me and I was told it was because I "discussed a new issue" with my doctor. 1. - I didn't. He asked if I needed a refill for a condition I've had for 20+ years. I said yes. B. Even if I did bring up a minor issue, do they not want us to answer honestly when they ask us health questions or ask if we have any concerns? We should just say nope!

Then it happened again with my daughter at a completely different practice. The NP (because of course the ped doesn't do physicals) decided she wanted my daughter screened for a minor issue by a specialist. An issue that we did not ask about and were not concerned about. So she handed me a piece of paper with some pre-typed names on it. Turns out that writing "referred patient for X" is enough to get you billed for an "office visit." So then I took my daughter to said specialist (another $150+) for them to laugh and say my daughter definitely does not have X condition. And then I received the bill from the Ped's office for an "office visit" instead of the well visit.

In both cases, the conversation about the "issue" was less than 60 seconds and not initiated by me. After some back and forth and arguing I was able to get the charges removed. But both required persistence, multiple phone calls and talking to more than one person. Which I guess they are counting on a certain percentage of people not doing. In both cases they acted like they are doing me a favor rather than correcting their own error (best case scenario) or outright billing fraud (worst case scenario.)

So just, be very aware and vigilant for this, particularly if you are on a high deductible plan.

Yes, this is becoming very common. My GYN asked me about an issue during my annual and then billed for it.

Sadly, I think you have to go into the appointment and state you are there for preventive care and don’t authorize care or billing for additional issues. Just another day in healthcare in the greatest country in the world.

Nothing works. I have tried it. I think unless you are armed with a recording device and tell the dr that you will not be overcharged or authorize care for additional issues...and follow up with a lawsuit if they do charge you...you have no recourse.

In the meanwhile, when I go back to my country of origin, I have a team of doctors there for all my routine checkups. I even get my medicines from there.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It’s a billing thing. The preventive care visit diagnosis code doesn’t include any of these other things that were addressed. So if thyroid or anxiety meds were refilled, or patient was referred to Derm for a skin concern or whatever it was, those have separate diagnosis codes and need to be linked to a separate office visit. Many health care offices have signs in waiting room letting people know that this will happen during a PCV visit. Listen we (health care providers) hate it too. But electronic medical record systems kind of require you to play by insurance company and billing rules.

It never happened to me until last year. It's a money grab.

Doctors are getting squeezed too. It's a billing thing. They could have, probably should have, always been doing it. Now the ones who were lax are doing it too.

You're just going to scare people away, or make them afraid to say anything to you that could be construed as an "issue." Also, as I stated, I didn't even raise any of the issues in question. The doctors did. That is some shady BS. I'm going to start all future visits with a disclaimer to the doctor that I don't wish to discuss anything that will convert my well-visit to an "office visit." If that isn't okay with them, I will find someone else.

Yes. This is what you have to do.

I have a person who managed my meds and she made an error. I said I did not want to be charged extra for an "in-between" request. But she waived the fee -- as she should have -- because she is the one who prescribed the wrong number of pills.

If she had not waived the fee, I'd be finding someone else.

[Anonymous]

Anonymous wrote:A free preventative care visit (or a “checkup”) is for the appropriate health screenings ONLY. If you have other concerns, you are likely going to pay your copay. It’s not new or a scam, except to the extent that the entire system is a scam.

What are those screenings? The PCP isn't going to do a mammogram or a colonoscopy or a pap smear or a proper skin check or a cardiac assessment or an eye exam or vaccinations. Mine just checks off on the computer that I've had these things done by other specialists or providers. I only turn up because the system pretends this person coordinates my care and because I have to write the name of a PCP on forms. Maybe it's more useful for someone else not already seeing a team of specialists.