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This is what I want to know as well. I don't pay for wellness visits. My doc would have noticed the infection and written a script for a Z-pac and continued checking my child out. When we go for sick visits we pay $20 and that's it. Is your peds out of network for your plan?
Some high deductible plans don't have co-pays regardless of in-network or out of network.
If you take your car for an oil change and the mechanic notices it needs a new air filter do you not pay for it?
In general, auto mechanics charge by the hour, so you are paying for extra labor and for the part. In the case of a doctor, the labor cost is only for a single visit, so I don't see that you should pay for two visits for something like this. No matter what insurance code you bill under, you should only be charged for a single visit and the prescription.
In general, auto mechanics charge by the hour, so you are paying for extra labor and for the part. In the case of a doctor, the labor cost is only for a single visit, so I don't see that you should pay for two visits for something like this. No matter what insurance code you bill under, you should only be charged for a single visit and the prescription.
As I said in a previous post of course you should only be billed for one visit, but the bill would be different depending on what type of visit it is. If indeed the OP was billed twice, that is an error. If he was charged for a sick visit and not a wellness visit, that is something he needs to speak with the doctor's office about.
So your Dr would say "it looks like your child has an ear infection. Do you want me to prescribe medication or would you rather go elsewhere?"
I know doctors have special training and command a high salary, but this just seems low to me. It's not like I took my daughter in for a wellness visit and asked for a free mri.. she looked in her ears and told my wife her ear was infected and she would write a prescription. I fail to see what extra service I was given. Certainly not to the point as to be charged the same as if I came back again the next day for a seperate appointment. Rich will get richer I guess.
Actually, yes. My OB/GYN discovered a health issue during a routine physical. She told me I needed to make a separate appointment or all of the tests that she ran that day would be considered diagnostic instead of preventative, and I would be billed accordingly.
I'm not saying it's right, or that I agree with it, I am saying that I have experienced it, more than once. My doctors were upfront about how their offices bill, so I had the option of making an appointment or letting them treat the issue then.
Did the doctor also bill for a wellness visit? The doctor has to write certain codes when he/she prescribes medication, so it makes sense that it would be billed as a sick child visit.
Last edited by raindrop101; 05-21-2015 at 10:46 AM..
If indeed you were charged for 2 visits in one, that was likely an error and they cannot do that. It is more likely that you were charged for services that would normally be performed during a well visit, but the doctor charged you her sick visit rate for her consultation.
I doubt they were charged for 2 visits. I would bet that the EOB shows that the child was seen for a well visit and an accompanying visit for the ear infection and they are being billed accordingly.
Quote:
Originally Posted by Zimbochick
If you take your car for an oil change and the mechanic notices it needs a new air filter do you not pay for it?
Exactly!
Quote:
Originally Posted by Spazkat9696
No, I go home and tell my husband who can get one a lot cheaper at the auto parts store and install it for free. This is like a bait and switch. The OP wasn't seeking treatment. If the OP wanted treatment the OP would have made an appointment for it. The whole point of the visit was to check everything out and to make sure the child was well.
If the OP wasn't seeking treatment and didn't want the child's ear infection taken care of at that visit, then she should have said something. It's a bit foolish to do so, but that would be one way to not pay the $161. The point of the well visit was to check development, growth, give immunizations, etc. The extra service, the check for the ear infection, was just that, extra. It's very clearly spelled out what constitutes a "well" visit and anything above that, physicians can and do charge for those services. Why would anyone think that they should be getting services from their doctor for free? It's not bait and switch, not even close.
Actually, yes. My OB/GYN discovered a health issue during a routine physical. She told me I needed to make a separate appointment or all of the tests that she ran that day would be considered diagnostic instead of preventative, and I would be billed accordingly.
I'm not saying it's right, or that I agree with it, I am saying that I have experienced it, more than once. My doctors were upfront about how their offices bill, so I had the option of making an appointment or letting them treat the issue then.
Did the doctor also bill for a wellness visit? The doctor has to write certain codes when he/she prescribes medication, so it makes sense that it would be billed as a sick child visit.
Yes. I was billed for a wellness visit (covered 100%) as well as a sick visit. I don't have a Co pay. I pay 100 percent until I hit 2500 deductible. It's a pretty crappy amount but nothing I can do.
Yes. I was billed for a wellness visit (covered 100%) as well as a sick visit. I don't have a Co pay. I pay 100 percent until I hit 2500 deductible. It's a pretty crappy amount but nothing I can do.
You were not billed for a wellness visit, you were billed for the sick visit you changed your well visit to when your child was sick. Again, talk to your doctor but they are well within their rights to bill you for a sick visit. What I would be more concerned with is the 15 minute well baby check and not so much they charged you because you brought your sick child in to be seen.
My 3 year old just went to the Dr for her yearly wellness visit. 2 days before the visit she got a cold and a cough. When we took her in, they said she had an ear infection and prescribed medicine. The wellness visits are always covered by insurance 100%, but I was billed $180 for a separate doctor visit. Checking her ears was part of the wellness check, but apparently the fact that she had an ear infection means they provided additional service in telling us about it and prescribing medicine.
I'll spend ANY amount of money on my kids, but I can't help but feel this is a cash grab. Was 30 seconds of additional work really worth charging us for a separate visit? I called the billing office and appealed it. They denied it and said they would need to have it paid in full.
Thoughts?
Call the insurance company and ask them. This means that you are owed a well visit.
Did they give her vaccines? If they did, then I agree it's a well visit and her cold wasn't enough to prevent the vaccines.
Because of ACA (aka Obama care) all preventive care must be covered 100% by insurance. So she got her wellness check, paid for by the insurance. Shady practices to charge for a minor issue on top of that. I mean, it was quite minor! Isn't that is what a wellness visit is for, to check if the child is well? So if they find something, they charge you for a sick visit. I don't get it. Maybe people are making their wellness visits when their kids get sick so they don't have to pay and this is a way to stop them.
I think the OBGYN one made sense because they were going to have to run tests and give results, etc. But they already looked in the kids ear and spent 5 seconds writing a script. I think its unethical.
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