Dr. office visit time limit? - Page 2

lovesrecess · ‎03-14-2010

I have to take two meds that are classified as controlled substances. Hence the rules. The pharmacy just faxes the dr office for the other ones.

millieshops · ‎03-09-2010

I do know they work against time limits, but I also have seen my insurance company pick up a bill for an extended office visit - minus my usual co-pay.

do you know why your insurance didn’t pay for the basic office visit?

Still Raining · ‎03-30-2014

There are only about four codes that should been used. It is not strictly time based, but rather based on history, decision and examination.

In order to appeal you will need a detail bill and a complete office visit printout. Then you take it up with your insurance.

hckynut · ‎03-10-2010

@lovesrecess ,

Yes I have heard of this. My nephew-in-law is a doctor. He quit with one of his practices precisely for that reason. He was told he had to limit his time with each patient. Each day he would get the list of his patients they had scheduled for him to see.

Along with that list he was expected to adhere to X number of minutes with each patient. So in order for him to visit with his patients on the time he wished to spend with them, he at times was in the office until 8-9pm. He did that on essentially was "his time".

He left that practice and now is with the same group as my PCP, and there is not structured, or allotted time per patient. He looks at his schedule for the following day/sees who his patients will be, and the reason for their visit.

If he gets to far behind he tells the one doing the scheduling to see if the patient can change their appointment day. That is what he does and to my knowledge that is working well for him and his patients.

I have several doctors, 2 of which are also good friends. There have been times when I have had to wait "in the exam room" longer than I expected. That happens to the best of them and I get it.

Do they spend more time with me because I am their friend? I have no idea, but those I have referred to them, are still seeing them. They also have never mentioned any problems such as this.

As far as what they charge? To me that is a whole different category than "time spent" with a patient. Insurance companies are a whole different animal and I have had umpteen battles with them over decades.

hckynut

hckynut(john)

roster · ‎10-09-2017

Ask billing to change the billing code. If your MD has given patients email access, email him the situation and ask to have it coded so your insurance will cover the visit.

roster · ‎10-09-2017

@fthunt wrote:
If you can't settle with the doctor's office for a reasonable amount....report his policy everywhere you can......a Medical Society in your area....Better Business Bureau.......
and change doctors.

(sorry I hit BOLD some how)

Don't waste your time & energy!

Sooner · ‎03-10-2010

I was admitted to the hospital from the ER once and my husband stood over my bed telling me that he had called the insurance company and there would be no problems.

I said "Sure", threw up, and six months later I was still arguing with them: WITH THE NUMBER they had given my husband and he had dutifully written down at the ER!

SXMGirl · ‎07-07-2010

@lovesrecess What you described is outrageous. Before I would pay that ridiculous bill, I would talk to the doctor directly. If that does not work, maybe send the doctor your own bill for time spent waiting to see him.

My current doctor limits visits to 15 minutes, but sometimes the visit does go over that and I have never been billed, nor do I ever plan to pay such a bill.

The next time that I hear salt and ice together, it better be in a margarita!

Carmie · ‎10-25-2010

@lovesrecess wrote:
Just got a bill from my dr. It is for $525. It was a routine follow up visit for refills. I called and they said it was because an office visit can only be 25 minutes. The dr spent 32 minutes with me, so they added the code for "extended office visit." I told the woman that I had waited in the exam room longer than 32 minutes for the dr. No way was he there more than just a few minutes, maybe 15 at the most. I am livid. Humana rejected the entire amount....guess I will set my timer on my phone next time and when the 25 minutes alarm sounds, I will tell him his time is up! Have you ever heard of this?

What was the reason Humana rejected the claim?

Is the doctor participating with your insurance?

Are you responsible to pay the bill?

Doctor visits can be billed many ways and there are many codes that are used for how involved or extensive they are.

EatWell · ‎12-31-2012

@lovesrecess wrote:
Just got a bill from my dr. It is for $525. It was a routine follow up visit for refills. I called and they said it was because an office visit can only be 25 minutes. The dr spent 32 minutes with me, so they added the code for "extended office visit." I told the woman that I had waited in the exam room longer than 32 minutes for the dr. No way was he there more than just a few minutes, maybe 15 at the most. I am livid. Humana rejected the entire amount....guess I will set my timer on my phone next time and when the 25 minutes alarm sounds, I will tell him his time is up! Have you ever heard of this?

@lovesrecess

Yes.