Make that the state of Minnesota. The headline "Questions Can Trigger ‘Split Visit’ Charge At Doc’s Office" recently popped up on the website of the Minnesota CBS affiliate. It seems that a patient was charged for an extra physician visit for asking too many questions. Park Nicollet Health Services told the reporter:
"Medical services are carefully coded
for insurance purposes. As Park Nicollet explained
to us, the billing has to accurately reflect the
medical services provided. If the doctors feel their
work goes beyond the scope of the visit, they must
code that on the bill. That’s to assure that coverage
for a “wellness” visit doesn’t fraudulently cover
care given to an “acute care” matter."
for insurance purposes. As Park Nicollet explained
to us, the billing has to accurately reflect the
medical services provided. If the doctors feel their
work goes beyond the scope of the visit, they must
code that on the bill. That’s to assure that coverage
for a “wellness” visit doesn’t fraudulently cover
care given to an “acute care” matter."
This highlights two fundamental problems with health care, in my mind. We all know that primary care physicians already have too much to accomplish in one visit. Visits have to be short though, in order to see more patients (we'll leave out any financial implications).
However, I think many would agree that an educated and engaged patient can be appreciated by most physicians. In an ideal world, physicians would be able to address each of their patient's concerns and answer patient questions.
Unfortunately we live in this country. Should physicians be able to code patient counseling or phone "visits"? Yes. Should insurance companies be able to take advantage of what should be routine care? With physicians not seeing a nickel of the additional charge? Why do we even have to ask that question? In a written statement (reported by the CBS affiliate):
However, I think many would agree that an educated and engaged patient can be appreciated by most physicians. In an ideal world, physicians would be able to address each of their patient's concerns and answer patient questions.
Unfortunately we live in this country. Should physicians be able to code patient counseling or phone "visits"? Yes. Should insurance companies be able to take advantage of what should be routine care? With physicians not seeing a nickel of the additional charge? Why do we even have to ask that question? In a written statement (reported by the CBS affiliate):
"In a written statement, the medical provider
said that 'the insurance company may require
that patients pay or make a co-pay for services
beyond the ‘preventive’ part of the
appointment.'”
The statement goes on to say that the total
amount billed to the insurance provider is the
same as if it were one appointment, only
it’s 'broken out separately on the invoice.'"
said that 'the insurance company may require
that patients pay or make a co-pay for services
beyond the ‘preventive’ part of the
appointment.'”
The statement goes on to say that the total
amount billed to the insurance provider is the
same as if it were one appointment, only
it’s 'broken out separately on the invoice.'"
The Daily Kos called the new policy bullshit. I can't say that I disagree. They spell it out better than I. "You see, asking a question about an actual problem means your annual physical has been turned into a different kind of visit -- one that is not 'free' from deductibles or cost-sharing payments under Affordable Care Act rules as is the case with physicals and other preventive care like immunizations."
I see this instance opening a door for door for eager insurance companies. The question is: what can we do about it?
I'd love to hear your thoughts.
I see this instance opening a door for door for eager insurance companies. The question is: what can we do about it?
I'd love to hear your thoughts.
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