SICK Visits vs Well visits or Both?
Sick Visit -- This is an office visit for an acute problem or flare-up of a chronic problem. This could also be an office visit to follow up on chronic problems (ADHD, nutritional, counseling, asthma, ear infections, new or refill prescriptions, review and discussion of ongoing treatments or concerns)
Well Visit -- This is an office visit for a routine physical exam or yearly health maintenance exam.
Sick/Well Visit -- This is a combination visit of a routine physical exam where an acute or chronic issue is addressed as well. For example, if you presented today for a well visit and you have an acute or chronic issue you would like addressed, it is considered a combination visit and must be billed differently than just a well visit or just a sick visit.
Why it is billed differently -- It is billed differently to account for the additional work, expertise and time required for a combination visit (additional lab work, x-ray, referrals and; /or prescription medications). It involves additional documentation as well. Our insurance contracts require we bill for ALL services rendered.
How this affects me -- Although many insurance companies acknowledge the sick/well visit combination, some of them still require the patient to pay co-pays or have additional costs applied to the annual deductible.
ANNUAL PHYSICAL EXAMS
Annual physical exams target preventative care and are billed as such. Medication refills and/or other ailments injuries, or illnesses addressed during an annual physical exam are billed IN ADDITION to the annual physical. These charges may be passed on to the patient. Please check with your insurance company to confirm your coverage for all types of doctor visits.
We realize this can be confusing, and if you have any questions or concerns after reviewing this material, please ask.
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