Annual Physicals - Your Insurance and Our Office
Many of the services provided in this office are covered and paid for by your insurance company.
Unfortunately, not all services are paid by insurance. In cases where the service has not been paid, you will be personally responsible for the bill. Before we bill you, we will make sure that all of the information provided to the insurance company is accurate and clearly describes the services you received.
INSURANCE FILING AND THE LAWFederal laws addressing all insurance companies require that we submit claims to an insurance company accurately, reporting the exact services performed and the exact reason for performing them.
We are not allowed to change this information just so an insurance company will pay the claim.Our practice is committed to these laws, and will submit claims to all insurance companies in this manner.
“ANNUAL EXAMINATIONS”As a commitment to your health, we recommend that every patient have an “annual exam” that allows us to evaluate your overall health picture, and make sure you are not developing any unexpected problems or illnesses.
During this visit, we will update all of your known conditions, as well as look for any new problems. If additional complaints or medical problems are addressed during the physical examination, a second charge is generated for an established patient visit in addition to the physical. Unless there is some major new fi nding during this exam, we must submit the service to your insurance as an annual examination, which your insurance may not pay for.Along with the examination, your doctor might suggest that some “screening” tests be done to allow him to get a better “picture” of your health. Your insurance company may also consider these services non-covered, and you will be expected to pay for them yourself.
Even if the results of these tests show some problem, we must submit them as “screening” to your insurance company, and cannot change the information on the claim just to receive payment for the services from the insurance company.
We will be glad to work with you on payment plans for non-covered services, but these arrangements must be made in advance.
Non-Covered Services Are YourResponsibilityInsurance companies do not pay for all medical services, even though it might be helpful to the patient.
When a service is not covered by your insurance policy, you will be responsible for paying the bill.
We cannot change information on an insurance claim just so the claim will be paid.
If you are not sure if a service is covered by your plan, you will need to call your insurance company in advance to see if you are going to be responsible for payment.