topic Re: Question about upcoming physical checkup in Wellness

Question about upcoming physical checkup

SeaMaiden — Sun, 30 May 2021 15:32:52 GMT

It has been 4 years since I had a complete physical.

I heard it is best not to bring up any "concerns" as they code physicals different if you mention ISSUES you are concerned with. Then you are charged a fee When a yearly exam is normally free.

Should I make seperate appointment for the two concerns I have? How would you handle this.

Re: Question about upcoming physical checkup

Etoile308 — Sun, 30 May 2021 15:38:31 GMT

I've never been charged an additional fee for discussing issues during my yearly examine. I would think if you had concerns you'd want them addressed as soon as possible. What would be the point in paying for a later visit to discuss your concerns? That to me is the purpose of a yearly physical.

Re: Question about upcoming physical checkup

LuvmyLab — Sun, 30 May 2021 15:39:13 GMT

I just had my annual physical a few weeks ago and I had a number of questions to ask my doctor. It is just billed as an annual physical. This is the time to definitely bring up any concerns you may have to your doctor. I don't know why it would be billed differently if you bring up things you are concerned about. A physical is a physical.

Re: Question about upcoming physical checkup

Linmo — Sun, 30 May 2021 15:41:04 GMT

@SeaMaiden I have a yearly physical with either my primary care doctor, my gyn or both. For my health system, it doesn't matter what you bring up during the appointment, it's how they schedule it when you make the appointment.

If I schedule it as my annual checkup, it's free, unless it's been less than 12 months since the last one. If I schedule it for some other reason, then I am charged a co-pay.

Re: Question about upcoming physical checkup

SeaMaiden — Sun, 30 May 2021 15:54:55 GMT

@Linmo wrote:
@SeaMaiden I have a yearly physical with either my primary care doctor, my gyn or both. For my health system, it doesn't matter what you bring up during the appointment, it's how they schedule it when you make the appointment.
If I schedule it as my annual checkup, it's free, unless it's been less than 12 months since the last one. If I schedule it for some other reason, then I am charged a co-pay.

@Linmo Ok. Thanks

Re: Question about upcoming physical checkup

gizmogal — Sun, 30 May 2021 16:07:00 GMT

Your doctor will use the code for annual physical for the billing. Your appointment was for a physical and he/she will bill that way.

Most thorough doctors actually ASK if you are experiencing any discomfort, pain or symptoms of any type that are new/different/worrisome. They consider that inquiry part of a physical because it gives them insight to the lab tests to focus on since blood is drawn at every physical. A comprehensive physical includes asking the patient how she is feeling and if there is anything special that brought you in.

So then you answer with your two concerns. You can add that you don't want to pay for anything in this visit and want to the billing just as the "free" physical and the doc will get what you're saying. It's not like the doc doesn't understand your copay "concerns", too! The doctor may suggest a follow up appointment to go over the lab tests and to discuss your concerns at that time.

My best advice: doctors function best when you don't hold back concerns that might need attention. They do best when they take your physical results in context with how you report your state of health and any dymptoms or conditions you experience .

And don't wait 4 years to take a physical. Poor judgment! Maybe you can believe your body is functioning perfectly in your 20's, but if you're over 35 or 40 you should see a doctor once a year for standard lab tests and a once over. If you're over 50, you should definitely not skip a year.

Re: Question about upcoming physical checkup

millieshops — Sun, 30 May 2021 16:11:19 GMT

@SeaMaiden Are you asking about the annual Medicare wellness visit? That's really not so much of a physical exam as much as it is an attempt to ferret out issues that often come with aging - I'm thinking balance, memory, depression, etc.

When I was a few years younger than now, I wasn't at all sure that visit was really valuable to me, but as I very quickly keep adding years, I realize that visit is often the only time I make myself confront what being 75+++ really means. Right now my physical aging issues aren't terrible, so I tend to shove them into my subconscious until I am talking to the doctor! (It's been decades since I lived with someone, which makes that easy except when a real problem presents.)

My doctors were both gave me time to renew scripts for meds and testing and I was able to address issues without any extra charge, but I don't believe I ever spent much time that way in the wellness visit. I did pay extra on the visit when I needed a pneumonia shot as well as one for flu.

From my point of view, one of the best things about the wellness visit is that the doctor is paid to consult with the patient for a longer time than a routine office visit lasts in either of those offices at least. As usual, local info is probably your best guide.

Re: Question about upcoming physical checkup

skatting44 — Sun, 30 May 2021 16:28:25 GMT

It was either my Health Insurance or my Primary Care Physicians group that sent me info that any new problems need to be addressed at a separate office appointment rather than at my yrly physical due to billing . So, yes I've heard this .

Re: Question about upcoming physical checkup

Still Raining — Sun, 30 May 2021 16:22:22 GMT

The Medicare Wellness Visit is mainly a review of ongoing orders, tests and rx. They can order them. Then you have the weight, diet and exercise 😱

If you have a concern you will need a other type of visit. The concern can be only partially covered during the wellness.

You could well need both.

Re: Question about upcoming physical checkup

ValuSkr — Sun, 30 May 2021 16:23:22 GMT

I don't know about your question but you're right about one thing - most doctor offices work every angle to maximize revenue and/or insurance company reimburesments. In the past, it's worked in my favor. Routine eye exams weren't covered by my insurance but because of an eye condition I had, the opthalmologist was able to get insurance reimbursement for the exam.

Re: Question about upcoming physical checkup

mom2four0418 — Sun, 30 May 2021 16:35:52 GMT

@SeaMaiden wrote:
It has been 4 years since I had a complete physical.

I heard it is best not to bring up any "concerns" as they code physicals different if you mention ISSUES you are concerned with. Then you are charged a fee When a yearly exam is normally free.

Should I make seperate appointment for the two concerns I have? How would you handle this.

I would call and speak to someone in the doctor's office, for the most accurate information.

Re: Question about upcoming physical checkup

tobes — Sun, 30 May 2021 17:38:50 GMT

@gizmogal @SeaMaiden Today's physical is mostly driven by blood work after blood pressure and urine sample is taken at time of the physica. . I gave up EKG's because some believe that results are only as good as the day they are taken although the doctor can eamine the results for any difference from year to year

Re: Question about upcoming physical checkup

Carmie — Sun, 30 May 2021 17:52:50 GMT

If you have Medicare, ask whatever questions you wish and bring up your list of concerns.

The doctor will not be billing Medicare or an Advantage plan for a physical. Medicare does not cover physicals. The doctor will use a code for either a wellness visit (probably not) or an office visit to recheck a previous concern.

Re: Question about upcoming physical checkup

Effie54 — Sun, 30 May 2021 19:26:42 GMT

Why would you want to make 2 appointments? When the doctor asks if you have any concerns, talk about it when you're there. So what if they coded a little differently and you have a copayment. If you go back for another visit, you're going to still pay another copayment.

Re: Question about upcoming physical checkup

SilleeMee — Sun, 30 May 2021 19:32:35 GMT

When I go in for a wellness check I ask for specific blood tests. I tell my doctor that I want to know what my specific numbers are. My doctor knows that I am proactive with my health and that I'm not there to look for problems. I just want to know the status of my current health condition by examining my numbers. I don't have any concerns other than that.

Re: Question about upcoming physical checkup

Icegoddess — Sun, 30 May 2021 19:40:15 GMT

@SeaMaiden I do remember a long thread about 2 years ago about this subject. It seems to depend on your insurance carrier and what THEY consider a physical. I would suggest you call your doctor's office and speak to someone in billing as they probably know more about how things are coded. You also could call your insurance company and ask them, assuming anybody will actually talk to you.

From what I remember in the earlier discussion, it seemed Medicare's definition of a "physical" didn't even include bloodwork, but I could be incorrect. I'm still on the overly expensive ACA plan.

Re: Question about upcoming physical checkup

SeaMaiden — Sun, 30 May 2021 19:42:38 GMT

@Icegoddess wrote:
@SeaMaiden I do remember a long thread about 2 years ago about this subject. It seems to depend on your insurance carrier and what THEY consider a physical. I would suggest you call your doctor's office and speak to someone in billing as they probably know more about how things are coded. You also could call your insurance company and ask them, assuming anybody will actually talk to you.

From what I remember in the earlier discussion, it seemed Medicare's definition of a "physical" didn't even include bloodwork, but I could be incorrect. I'm still on the overly expensive ACA plan.

@Icegoddess I believe the secondary insurance should cover what Medicare does not? I pay $785.00 a month for DH and I for blue cross Premera coverage along with or Medicare.

Re: Question about upcoming physical checkup

Icegoddess — Sun, 30 May 2021 19:50:38 GMT

@SeaMaiden wrote:
@Icegoddess wrote:
@SeaMaiden I do remember a long thread about 2 years ago about this subject. It seems to depend on your insurance carrier and what THEY consider a physical. I would suggest you call your doctor's office and speak to someone in billing as they probably know more about how things are coded. You also could call your insurance company and ask them, assuming anybody will actually talk to you.

From what I remember in the earlier discussion, it seemed Medicare's definition of a "physical" didn't even include bloodwork, but I could be incorrect. I'm still on the overly expensive ACA plan.
@Icegoddess I believe the secondary insurance should cover what Medicare does not? I pay $785.00 a month for DH and I for blue cross Premera coverage along with or Medicare.

@SeaMaiden sorry, I really know nothing about Medicare and it's supplements. Hubby is on it, but I'm not. We pay over $950/month just for ME on an ACA "cheap" plan, and that is the only carrier available to individuals in the state.

Re: Question about upcoming physical checkup

Mom2Dogs — Sun, 30 May 2021 19:54:19 GMT

@SeaMaiden If you are talking about the Medicare well check vs a doctor appointment, from my experience....you cannot bring up issues you are having during your medicare visit or you are charged differently (more money).

If it were me I'd just schedule an appointment and get things taken care of in 1 visit...just my opinion.

Re: Question about upcoming physical checkup

chlema — Sun, 30 May 2021 20:46:34 GMT

My wellness exam last year consisted of bp and weight/height check, going over my current medications, asking if I needed renewals. I then had to draw a circle, numbered it as a clock and make the hands point to 2:45. Before doing that she gave me 3 words to remember (apple, table, penney) and asked me to repeat them about 10 minutes later. Asked about my balance, had me walk to the door and back at a brisk pace. Gave me paperwork for bloodwork, listened to my heart and lungs and that was it. I did not have any concerns but did have the impression I could address them if I did..

This year I'm just telling her to forget the memory thing and will throw the apple, table penney back at her lol.