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

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

So you should just stand there in a starfish position and say nothing? What is the purpose of this visit? Please define "general preventative stuff".

Preventative care equals screenings. The kinds of tests that are out there to pick up problems early before people know they are an issue. There’s plenty of great info out there to help you understand what that means. Start here. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

So you shouldn't mention chest pain, headaches or gastro symptoms that might actually indicate cardiac issues or cancer. You shouldn't say you get out of breath going up the stairs. What kind of preventative care is that? How did doctors work in the 1950s when they didn't have this technology? Presumably they talked to the patient and asked questions.

Of course you should, but those all require diagnostic work up ( additional eval to figure out a problem) which is different than preventative care ( screening to detect potential future problems and prevent from becoming a problem). Those you get billed for.

So when the PCP asks those questions during a wellness check, they're just trying to turn it into another kind of visit? My PCP does ask about those symptoms.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

So you should just stand there in a starfish position and say nothing? What is the purpose of this visit? Please define "general preventative stuff".

Preventative care equals screenings. The kinds of tests that are out there to pick up problems early before people know they are an issue. There’s plenty of great info out there to help you understand what that means. Start here. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

So you shouldn't mention chest pain, headaches or gastro symptoms that might actually indicate cardiac issues or cancer. You shouldn't say you get out of breath going up the stairs. What kind of preventative care is that? How did doctors work in the 1950s when they didn't have this technology? Presumably they talked to the patient and asked questions.

Of course you should, but those all require diagnostic work up ( additional eval to figure out a problem) which is different than preventative care ( screening to detect potential future problems and prevent from becoming a problem). Those you get billed for.

So when the PCP asks those questions during a wellness check, they're just trying to turn it into another kind of visit? My PCP does ask about those symptoms.

No, believe me, we’ve all got too much on our plates as it is we’re not trying to turn it into another kind of visit. But if there’s a problem that requires additional eval and management (outside of normal screening) it needs to be billed correctly or all those medical coding folks will send it back

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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.

So you should just stand there in a starfish position and say nothing? What is the purpose of this visit? Please define "general preventative stuff".

Preventative care equals screenings. The kinds of tests that are out there to pick up problems early before people know they are an issue. There’s plenty of great info out there to help you understand what that means. Start here. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations

So you shouldn't mention chest pain, headaches or gastro symptoms that might actually indicate cardiac issues or cancer. You shouldn't say you get out of breath going up the stairs. What kind of preventative care is that? How did doctors work in the 1950s when they didn't have this technology? Presumably they talked to the patient and asked questions.

Of course you should, but those all require diagnostic work up ( additional eval to figure out a problem) which is different than preventative care ( screening to detect potential future problems and prevent from becoming a problem). Those you get billed for.

But the labs screenings are going to be billed separate anyway. Why not just skip the "preventative" appt, have the doctor call in any refills and labs and be done? It's essentially what's happening unless you want extra charges just in that appointment.

[Anonymous]

I can't believe there are people defending this. Trying to explain and commiserate, yes. But actually trying to defend it is a stretch too far.

[Anonymous]

Something similar happened to my 83 year old mother - this is in Delaware. She got a $200 fee because the doctor “discussed a preexisting condition” with her. My mom couldn’t even figure out what this was because she says they didn’t really talk at all. Also, the only thing she has is hypertension, which a cardiologist handles.

My mom called to complain, and at one point in the conversation she said the phrase “billing fraud”. The practice manager deemed this to be ”threatening language” and fired my mom from the practice! Now she doesn’t have a PCP. Although I’m not even sure what the heck her PCP was doing for her anyway.

I am a doctor, but am hospital based, and I have to say that I have no idea whatsoever what goes into my billing. It’s done by Epic and AI, and I’ve tried to fix errors but it will automatically revert back to what that system thinks it should be. It’s all broken and crazy.

[Anonymous]

Anonymous wrote:Something similar happened to my 83 year old mother - this is in Delaware. She got a $200 fee because the doctor “discussed a preexisting condition” with her. My mom couldn’t even figure out what this was because she says they didn’t really talk at all. Also, the only thing she has is hypertension, which a cardiologist handles.

My mom called to complain, and at one point in the conversation she said the phrase “billing fraud”. The practice manager deemed this to be ”threatening language” and fired my mom from the practice! Now she doesn’t have a PCP. Although I’m not even sure what the heck her PCP was doing for her anyway.

I am a doctor, but am hospital based, and I have to say that I have no idea whatsoever what goes into my billing. It’s done by Epic and AI, and I’ve tried to fix errors but it will automatically revert back to what that system thinks it should be. It’s all broken and crazy.

If you're a doctor you need to call up that practice and get some answers for your mom and in general. They've treated her abysmally (and possibly illegally) and you picking up the phone will actually help. My sister is a nurse (not even a doctor) and she gets to the bottom of things with elder care so fast and that's not even her area. We all need to work together.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Something similar happened to my 83 year old mother - this is in Delaware. She got a $200 fee because the doctor “discussed a preexisting condition” with her. My mom couldn’t even figure out what this was because she says they didn’t really talk at all. Also, the only thing she has is hypertension, which a cardiologist handles.

My mom called to complain, and at one point in the conversation she said the phrase “billing fraud”. The practice manager deemed this to be ”threatening language” and fired my mom from the practice! Now she doesn’t have a PCP. Although I’m not even sure what the heck her PCP was doing for her anyway.

I am a doctor, but am hospital based, and I have to say that I have no idea whatsoever what goes into my billing. It’s done by Epic and AI, and I’ve tried to fix errors but it will automatically revert back to what that system thinks it should be. It’s all broken and crazy.

If you're a doctor you need to call up that practice and get some answers for your mom and in general. They've treated her abysmally (and possibly illegally) and you picking up the phone will actually help. My sister is a nurse (not even a doctor) and she gets to the bottom of things with elder care so fast and that's not even her area. We all need to work together.

Sadly, I think you overestimate how much I can help even as a medical professional. “Professional courtesy” doesn’t really exist anymore - it’s all billing codes and quotas. If I have a doctor as a patient with a serious problem, then I will give them my cell and talk to them at length after work or on weekends, but that’s all I can do.

Anyway, I’m not in DE, the practice manager sounds like a witch, the doctors are at the mercy of the admins, and my mom won’t go back there because she says that they are “a bunch of crooks.”

The system is so broken. I keep thinking it can’t get worse… but I keep being proven wrong. Sorry everyone, but the doctors are stuck in the doom loop with you, and we hate it too! But we don’t know to fix it because most of us are legally forbidden to organize.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Something similar happened to my 83 year old mother - this is in Delaware. She got a $200 fee because the doctor “discussed a preexisting condition” with her. My mom couldn’t even figure out what this was because she says they didn’t really talk at all. Also, the only thing she has is hypertension, which a cardiologist handles.

My mom called to complain, and at one point in the conversation she said the phrase “billing fraud”. The practice manager deemed this to be ”threatening language” and fired my mom from the practice! Now she doesn’t have a PCP. Although I’m not even sure what the heck her PCP was doing for her anyway.

I am a doctor, but am hospital based, and I have to say that I have no idea whatsoever what goes into my billing. It’s done by Epic and AI, and I’ve tried to fix errors but it will automatically revert back to what that system thinks it should be. It’s all broken and crazy.

If you're a doctor you need to call up that practice and get some answers for your mom and in general. They've treated her abysmally (and possibly illegally) and you picking up the phone will actually help. My sister is a nurse (not even a doctor) and she gets to the bottom of things with elder care so fast and that's not even her area. We all need to work together.

Sadly, I think you overestimate how much I can help even as a medical professional. “Professional courtesy” doesn’t really exist anymore - it’s all billing codes and quotas. If I have a doctor as a patient with a serious problem, then I will give them my cell and talk to them at length after work or on weekends, but that’s all I can do.

Anyway, I’m not in DE, the practice manager sounds like a witch, the doctors are at the mercy of the admins, and my mom won’t go back there because she says that they are “a bunch of crooks.”

The system is so broken. I keep thinking it can’t get worse… but I keep being proven wrong. Sorry everyone, but the doctors are stuck in the doom loop with you, and we hate it too! But we don’t know to fix it because most of us are legally forbidden to organize.

Aww thanks for the frank response. Yes sometimes places are so bad you just have to wash your hands of them.