The Insurance & Medical Industry are crooked!

e1iterate

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As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that they have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
 
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The ole "slippery finger"
 
As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
I agree with you. Insurance and most medical practices are doing their best to be a for-profit business instead of being in the business of helping sick people or keeping people healthy.
 
I agree with you. Insurance and most medical practices are doing their best to be a for-profit business instead of being in the business of helping sick people or keeping people healthy.
Doctors too, are trying to survive the insurance company ********, fwiw.
 
What's fun is the doctor could be punished/not paid by the insurance for billing the "wrong code". Could have been how they run things there but Likely the doc charged the wellness code and it was changed by someone else to "optimize billing".

Not a hard and fast rule but most patients want good reasonable care and most doctors/clinical staff want to provide good, appropriate care. Then there's an ungodly amount of people and processes between those two entities making it absurdly complicated and downright illogical at times to make that happen.
 
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maybe its time we send them bills for asking about our health, a consulting fee, since its their job to be telling us
 
As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that they have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
100% agree. Got to the allergy doc today and had a huge debocal and I basically told them to take the allergy shots and put them where the sun doesn’t shine because they were just trying to get money off me. So now back to my doc to request the tests I want and maybe get some answers. All they have done is run tests to get my money. Well that stops now.
 
As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that they have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
I am 100% guessing here, but sounds to me like a big practice that is managed (vice a smaller one that cares about patients). I don't thin this is how it's done everywhere, my annual physical we go over meds and new scripts for allergies, the Doc writes them for year at a time. I don't get billed extra (and insurance pays for the visit). When we were in Virginia, the practice was smaller and lot's of things were standard. By the time we left the practice had been sold (at least 2 times) and like you noted, it seemed everything was 'extra'.

I'd look for another MD, but I am hesitant to blow up the industry based on that one visit - despite how crappy it ended up.
 
As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that they have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
Your Doc could have just not billed you for those few minutes and then it would fall under wellness right?
 
The medical industry and the medical insurance industry are both hopelessly corrupt and need to be blown up and rebuilt from the ground up. But it will never happen because there are a lot of people with a lot of power making a lot of money from them and they would never allow that faucet to be turned off.
 
As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that they have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
That sucks. Big or small practice?

My experience has been that some practices file multiple codes for docs talking about/addressing different things in an annual, and it adds up. Docs typically have no idea what things cost to patients, they’re focused on care. They’re just checking boxes on what they’re doing as prescribed by management. Shame it all doesn’t fall under one code once a year for a physical and then other codes if they need to follow up on something.
 
It seems like asking about your medication should be part of an annual check up. Failing to ask about it would be falling short of what they should be doing, right?
 
I have no frame of reference on the medical insurance/private medicine side of things, but can relate it to how I feel about fuel prices. I hate paying so much for gas, but love it when the oil companies I have in my portfolio produce strong earnings. I assume this applies here as well.
 
It seems like asking about your medication should be part of an annual check up. Failing to ask about it would be falling short of what they should be doing, right?
My doctor always reviews my meds and dosages at my annual check ups, I'd hope that would be considered a normal part of an overall wellness exam.
 
I agree and they put us at risk all the time. My son’s Remicade infusions were denied initially to the tune of $5K every 2 weeks. They finally approved it and reimbursed us. They give him the lowest dose recommended for over a year while he loses 40 lbs. The doctor finally got them to approve the dose he suggested which is the max for UC.
 
This would be a bill I don’t pay and Tell them they can pound sand. They are already getting. Reimbursed for my “wellness” visit and are trying to double dip.
 
My doctor always reviews my meds and dosages at my annual check ups, I'd hope that would be considered a normal part of an overall wellness exam.
Same here. I just pay whatever I have to pay without scrutinizing it so don’t know if I’m in the same spot as @e1iterate. With a family of 5, there always seems to be a medical bill coming in.
 
Your Doc could have just not billed you for those few minutes and then it would fall under wellness right?
Based off of my experience two years ago, yes. I wasn’t charged any extra for talking about something and then being prescribed a medication at that time.
 
It seems like asking about your medication should be part of an annual check up. Failing to ask about it would be falling short of what they should be doing, right?
Exactly my thoughts which is why I thought nothing of it during my visit. I took it as her doing her job and being thorough. I would have probably questioned her not asking about it honestly.
 
My doctor always reviews my meds and dosages at my annual check ups, I'd hope that would be considered a normal part of an overall wellness exam.
It’s apparently not. At least here, anyway.
 
This would be a bill I don’t pay and Tell them they can pound sand. They are already getting. Reimbursed for my “wellness” visit and are trying to double dip.
It’s crossed my mind. I’m not sure what the parameters are for collections on these kind of things and I have perfect credit which I’d rather not ruin.
 
What’s really sad is the industry being so messed up is pushing people away from the field.
 
As some of you may know, I moved back to TN after 7 years in the Carolinas. I am not very good when it comes to doing annual checkups with the Dr. much less going to the Dr. in general. The last time I went for an annual exam was 2 years ago, back in 2023.

Anyhow, I scheduled my visit here back on 4/17. I had a nice visit with the Dr. and no complaints with her service etc. During my visit, she took my vitals, did some bloodwork and asked about a medication that I listed that I had been taking. This was exactly the same conversation and things that were done when I went to the Dr. the last time in 2023 back in Charlotte.

Last week, I received a bill from this visit. I was perplexed as an "Annual Wellness" visit is fully covered under my insurance. I thought that maybe it was coded incorrectly so I called yesterday to inquire about it. The lady said she would follow up with me which she did today and put me in touch with the person over the practice. This lady tells me that because I discussed my medication with the doctor during my wellness visit that it doesn't fall under the annual wellness part and is considered a separate visit. My response was, I filled out paperwork and, in the paperwork, you asked me to list any medications that were prescribed to me which I did. The Doctor asked me about the medication during my visit, and I responded and elaborated my thoughts about it. I felt any good Doc would do this, right? So, I then asked them, should I have not answered the question? They didn't have a response to that of course and blamed the insurance company for how this works.

My problem here is that when I went 2 years back in Charlotte, it was the first time I met with that Dr. and that was the time this medication was prescribed to me. I never got a bill from them because of this. I understand different practices etc, but this office said it's because of the insurance. To me this is just another way to bleed money off people and honestly it just makes me not want to go back, nor talk about things that could be wrong out of fear that I might get charged for multiple visits. None of this was disclosed to me at the time as I went in on good faith that I was having a routine annual checkup and nothing more. At no point did this visit feel any different than the one two years ago.

After some back and forth trying to understand, the lady on the phone then proceeds to tell me that they have signs up in their offices that state this very scenario that I am calling in and questioning. At that point, I spoke up and said Well...that right there should tell you all you need to know if you need a sign up to disclose this and I am not the only person that has called in questioning this very thing. It's not right, you know it's not right but you're making bank off it, so it is what it is.

End of the day, it's just a racquet to bleed more money off of people. So, PSA to any of you guys going for your annual visit, be careful and make sure you understand this so you aren't caught by surprise like I was. FWIW, I felt the Doctor was great, but I was not expecting to be charged with a separate visit for answering her question about the medication I have been taking.
If you want to see clear corruption, you have to go to a country with "single payer" healthcare that also has private care. Friend had a shoulder seize up and she couldn't work like that. They said there were no appointments for months - 4 I think but it's been a while since this happened. Anyway, they asked if she had private coverage and said if she did, they could get her in the NEXT WEEK! Same doctor, same office but $$$$$ for the doctor with private care vs the public system.
 
It’s crossed my mind. I’m not sure what the parameters are for collections on these kind of things and I have perfect credit which I’d rather not ruin.
Start the process of fighting the claim with your insurance and make them adjust the billing. I did that with some hospital stuff when I asked for the itemized copy and found I was being charged $700 for advil.

My stance is I will happily pay for services but will not be price gouged or over billed. Once it’s fixed, if after insurance I owe money, we can talk.
 
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