Hi I’ve recently moved to a new city and am working to establish a new PCP in Massachusetts.
The health insurance through my employer covers all preventive care with the deductible not applying. I had a tele-health appointment to “establish care” with the provider and have been told by the billing department that this doesn’t count as preventive care. I tried contacting my insurance provider but was essentially told that I can attempt to appeal the charge through my insurer but it’s unlikely to go anywhere because the diganosis code is not for preventive care. I received diagnosis code Z71.89 which represents ‘other – specified counseling’.
I intended only to come in for a routine physical/screening but I’m learning that it’s impossible to do this without first coming in to “establish care” which is just a conversation about my medical history. I learned from contacting the medical office billing deparatment that apparently it’s impossible to see any physician for a physical without first “establishing care” with the provider which is $350 out of my pocket. I filed an appeal through the billing department to get the diagnosis code changed but am not very optimistic since I was told this is standard practice. Is this standard procedure for any medical provider? Are there any other appeal options for me here? It seems ridiculous to me that I have to pay out of pocket to tell my doctor my medical history and that doesn’t count as preventive care.
submitted by /u/micthalo45
[link] [comments]Hi I’ve recently moved to a new city and am working to establish a new PCP in Massachusetts. The health insurance through my employer covers all preventive care with the deductible not applying. I had a tele-health appointment to “establish care” with the provider and have been told by the billing department that this doesn’t count as preventive care. I tried contacting my insurance provider but was essentially told that I can attempt to appeal the charge through my insurer but it’s unlikely to go anywhere because the diganosis code is not for preventive care. I received diagnosis code Z71.89 which represents ‘other – specified counseling’. I intended only to come in for a routine physical/screening but I’m learning that it’s impossible to do this without first coming in to “establish care” which is just a conversation about my medical history. I learned from contacting the medical office billing deparatment that apparently it’s impossible to see any physician for a physical without first “establishing care” with the provider which is $350 out of my pocket. I filed an appeal through the billing department to get the diagnosis code changed but am not very optimistic since I was told this is standard practice. Is this standard procedure for any medical provider? Are there any other appeal options for me here? It seems ridiculous to me that I have to pay out of pocket to tell my doctor my medical history and that doesn’t count as preventive care. submitted by /u/micthalo45 [link] [comments]Read Morer/HealthInsurance