There’s evidence that my doctor is filing incorrectly to insurance. What am I supposed to do?

My primary doctor makes patients complete two appointments for the yearly checkup. The first is to draw blood and take down relevant info. The second is a week or two later where she goes over the blood work and does any relevant exams. No copay is charged for the first visit because of ACA, but the second requires a copay. She calls her office “boutique style” and says that is her way.

I have Horizon Blue Cross Blue Shield and have access to the “Health Manager” where info filed with my insurance shows up. Some of the things that show up are “joint pain”, “chest pain”, “abnormal ekg”, “contact with Covid19”. None of this is true and I feel like she’s just using these to make health insurance companies feel that the second visit and testing is warranted.

For example, she gives me a yearly holter monitor test. I don’t have any need for it because it all shows up fine and this year “chest pain” showed up on the health manager. I never mentioned chest pain so I feel she just sent that to health insurance so they would cover the unnecessary test.

I am switching to a different PCP next year because of this and am wondering if I should alert anyone that this is happening at this doctor?

submitted by /u/FrostyBaker2034
[link] [comments]My primary doctor makes patients complete two appointments for the yearly checkup. The first is to draw blood and take down relevant info. The second is a week or two later where she goes over the blood work and does any relevant exams. No copay is charged for the first visit because of ACA, but the second requires a copay. She calls her office “boutique style” and says that is her way. I have Horizon Blue Cross Blue Shield and have access to the “Health Manager” where info filed with my insurance shows up. Some of the things that show up are “joint pain”, “chest pain”, “abnormal ekg”, “contact with Covid19”. None of this is true and I feel like she’s just using these to make health insurance companies feel that the second visit and testing is warranted. For example, she gives me a yearly holter monitor test. I don’t have any need for it because it all shows up fine and this year “chest pain” showed up on the health manager. I never mentioned chest pain so I feel she just sent that to health insurance so they would cover the unnecessary test. I am switching to a different PCP next year because of this and am wondering if I should alert anyone that this is happening at this doctor? submitted by /u/FrostyBaker2034 [link] [comments]Read Morer/HealthInsurance

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