We often liken insurance statements to grocery store receipts – each service, procedure, lab and screening is itemized and billed separately. Sometimes, it is difficult to understand which portion is being reimbursed by your carrier and which is your responsibility. Our Billing Department fields a lot of questions about statements, often specific to confusion around well-visit appointments.
It is common for children to be treated for a condition beyond the scope of “routine” visit services, even during their annual, preventative well check. For example, discussion of ADHD, complications from premature birth, ear infections, asthma management or any other complex or acute medical issue do not qualify as “routine care” by insurance carrier definition. As such, insurance companies require us to both document and bill these treatments separately. These fees are in addition to the usual “well visit” fee, and often result in a bill being sent to you.
You can read more in this article from the American Medical Association.
33 Rock Hill Rd
1740 South Street
2365 East York Street