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.

I started noticing this at the pediatrician in 2019, when I had my 2nd kid. They pushed the “postpartum depression/anxiety questionnaires” at me at 3 of the early checkups, I want to say 1, 2, and 4 months? This was all pre-COVID too. I filled out the first two honestly, yes I had some symptoms, the pediatrician or the NP said/did nothing, then I got a surprise bill for $50 because the questionnaires were coded as “education” and health insurance plans don’t cover it. Fortunately I got those bills before the 4 month checkup and when they pushed the clipboard with the questionnaire on it, I pushed it right back and didn’t fill it out. And I definitely said the reason why and just got the usual mumble response.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So what is the point of the "office visit" if you aren't permitted to bring up anything? Why not just let people come in for any appropriate labs or screenings and do away with the visit all together?

This - especially if they won't refill prescriptions unless you do the visit. I thought my BP med refill was preventing me from having a heart attack but what do I know. Just have a robot do all my labs and vitals and permit the refills automatically.

The point of requiring a visit for refills is to prevent a robot/computer from automatically refilling your meds. People may be fallible but they also have judgment, unlike a robot/computer. Which is why we go to the doctor rather than rely entirely upon Google and Claude.

FYI

Then stick to Claude, friend. You and AI know better than doctors and a visit/copay is too much for you to pay for medical advice.

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".

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:So what is the point of the "office visit" if you aren't permitted to bring up anything? Why not just let people come in for any appropriate labs or screenings and do away with the visit all together?

This - especially if they won't refill prescriptions unless you do the visit. I thought my BP med refill was preventing me from having a heart attack but what do I know. Just have a robot do all my labs and vitals and permit the refills automatically.

The point of requiring a visit for refills is to prevent a robot/computer from automatically refilling your meds. People may be fallible but they also have judgment, unlike a robot/computer. Which is why we go to the doctor rather than rely entirely upon Google and Claude.

FYI

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".

It's a real battle with insurance companies getting clarification over everything. And I find it fascinating they'll never admit anything in writing, only over the phone.

I've discovered that to visit a dermatologist costs XYX pre deductible to look at just one mole, but to look at two, it basically doubles even if it is just one extra second time commitment. You have to explicitly tell the doctor you are only looking at X mole and nothing else is under consideration.

The whole system is abysmal. The more exposure I get, the less I like everyone involved, from the doctors to the healthcare bureaucracy. At this point I've stopped trying to be nice and am pretty blunt and direct and even rude in order to stop doctors from doing things I didn't go in for or when dealing with the bureaucracy, because being nice doesn't get you anywhere and no different a treatment than being rude.

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.

100% a money grab. Doctors today smart at the contracted rates they agree to in order to participate in various insurance plans. So, because they feel underpaid they perpetrate all manner of schemes to make up what they feel they are owed. It's straight up health care fraud. Most people understand that doctors can no longer be blindly trusted. That profession has enjoyed that perspective for decades. Nope. No more.

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.

Wait. It's not the doctors getting squeezed, is it? It's the private equity company that is getting the profits, right? So what you are saying is that the $150 is necessary so the head of the private equity company can get a larger boat.

Bingo

Anonymous wrote:

Anonymous wrote:So what is the point of the "office visit" if you aren't permitted to bring up anything? Why not just let people come in for any appropriate labs or screenings and do away with the visit all together?

This - especially if they won't refill prescriptions unless you do the visit. I thought my BP med refill was preventing me from having a heart attack but what do I know. Just have a robot do all my labs and vitals and permit the refills automatically.

The point of requiring a visit for refills is to prevent a robot/computer from automatically refilling your meds. People may be fallible but they also have judgment, unlike a robot/computer. Which is why we go to the doctor rather than rely entirely upon Google and Claude.

FYI

Anonymous wrote:So what is the point of the "office visit" if you aren't permitted to bring up anything? Why not just let people come in for any appropriate labs or screenings and do away with the visit all together?

This - especially if they won't refill prescriptions unless you do the visit. I thought my BP med refill was preventing me from having a heart attack but what do I know. Just have a robot do all my labs and vitals and permit the refills automatically.

So what is the point of the "office visit" if you aren't permitted to bring up anything? Why not just let people come in for any appropriate labs or screenings and do away with the visit all together?

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.

Anonymous wrote:

Anonymous wrote:This bugs me too.

I go to two places in my head.

1. Attempt to not bring anything up. They take my vitals and tests, just here for a “checkup.” Don’t say anything. When they ask stuff, answer normally, positively, “fine.” Etc.

2. Or, just forget about the free preventive. Go to my checkups, or anytime I want to go, and say all the things that bother me.

I would go with #2, but I really really hate the new doctor they assigned me, and I try to keep quiet. Must switch offices entirely, soon.

I’m just going to straight up say to the doctor “I’d love to answer your questions honestly, but I can’t because your biller will charge me for a full additional office visit even though I’m already here and we aren’t going over our allotted time.”

That makes sense. Then at the end of your free preventative appointment, you'll make another appointment for your specific questions. Two trips but only one copay. Win - I guess?

Yes, happened to me also. You also need to watch out for the follow-up telehealth visit to discuss the lab results, even when the results are all normal.