Doctors office is billing appointment as “establishing care” instead of a wellness appointment. This is causing me to have a copay. Is this right?

My regular doctor has moved, so I switched doctors, but within the same hospital/company. I went for my annual visit that should be covered by my insurance but because it was my first appointment with this doctor they said it was an “establishing care” appointment and I would have a $60 co-pay.

My insurance company said if they switch the billing to preventative care then it would be covered with no co-pay as wellness check ups are covered. Does it make sense for them to bill the way they did or should I ask them to change it?

Also, they scheduled me to come in at another date for a wellness appointment where I would then get a Pap smear. They said the doctor first likes to establish care and get to know you before doing a wellness appointment. But our appointment seemed like a regular wellness appointment. Just the standard, weight, blood pressure, questions they ask. I’m a 26 year old average healthy female and had the same doctor for a while so I’m not sure if this is all standard.

submitted by /u/marieau1991
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My regular doctor has moved, so I switched doctors, but within the same hospital/company. I went for my annual visit that should be covered by my insurance but because it was my first appointment with this doctor they said it was an “establishing care” appointment and I would have a $60 co-pay. My insurance company said if they switch the billing to preventative care then it would be covered with no co-pay as wellness check ups are covered. Does it make sense for them to bill the way they did or should I ask them to change it? Also, they scheduled me to come in at another date for a wellness appointment where I would then get a Pap smear. They said the doctor first likes to establish care and get to know you before doing a wellness appointment. But our appointment seemed like a regular wellness appointment. Just the standard, weight, blood pressure, questions they ask. I’m a 26 year old average healthy female and had the same doctor for a while so I’m not sure if this is all standard.
submitted by /u/marieau1991 [link] [comments]Read Morer/HealthInsurance

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