| Posted By |
Message |
Tiggeruth
I am a mom :-)
Member since 6/06 3433 total posts
Name:
Heidi
|
PSA - Well Visits
Word of advice - keep track of how many well visits you make in the first year. We were going on the schedule we were told and yet our 9 month check up ended up being the 8th billed well visit and you are only allowed 7 (some state law) and since he wasn't sick our co-pay doesn't work and we are being billed $180. It all seems like super unfair BS and I guess i should have kept better track but didn't realize how drastically the laws changed between my DD and my DS (they are 3 years apart). With DD I think we had something like 9 or 10 well visits and the drs office seemed to have kept track of it but not this time. Its so frustrating. I wanted to post so others can keep it in their heads too just in case. If we had known in advance I they could have billed it as something other than a well visit but to change the billing now could be insurance fraud.
|
Posted 6/30/15 4:09 PM  |
| |
|
Long Island Weddings
Long Island's Largest Bridal Resource |
Jenn79
One more?
Member since 2/12 2410 total posts
Name:
|
Re: PSA - Well Visits
That's good to know. I split up their shots. Are those visits considered well visits? Or could they bill under something else? My ds is 3 months and we've been there 4 times already for shots and a weight check.
|
| Posted 6/30/15 4:28 PM |
| |
|
AliceCullen
LIF Adult
Member since 6/08 1497 total posts
Name:
|
Re: PSA - Well Visits
Is this for all insurance companies?
My son goes every month for a well visit for the first 6 months and then every other month until a year. We'll definitely be there for more than 7 well visits. Should we ask them to bill them as a sick visit?
|
| Posted 6/30/15 4:34 PM |
| |
|
Tiggeruth
I am a mom :-)
Member since 6/06 3433 total posts
Name:
Heidi
|
Re: PSA - Well Visits
Posted by AliceCullen
Is this for all insurance companies?
My son goes every month for a well visit for the first 6 months and then every other month until a year. We'll definitely be there for more than 7 well visits. Should we ask them to bill them as a sick visit?
I would ask. When I spoke with my insurance company, who was more helpful than the drs office honestly, they explained that its 7 well visits by law now between birth and 1 year and then its another 7 between 1 and 4. When DD was born we had a lot of weight checks and the drs office billed some of them as something other than well so that we'd have enough well visits and i remember from that time she had 11 for the year. 11 is a LOT more than 7.
|
| Posted 6/30/15 4:40 PM |
| |
|
MrsO
Big Brothers to Be
Member since 1/07 4521 total posts
Name:
Maureen
|
Re: PSA - Well Visits
Posted by Jenn79
That's good to know. I split up their shots. Are those visits considered well visits? Or could they bill under something else? My ds is 3 months and we've been there 4 times already for shots and a weight check.
When I go for just a shot because we spread them out to - I would pay a copay where for the well visits I do not have a copay. I think the dr. just bills for a vaccine and office visit.
|
| Posted 6/30/15 5:04 PM |
| |
|
alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
|
Re: PSA - Well Visits
Posted by Tiggeruth
Posted by AliceCullen
Is this for all insurance companies?
My son goes every month for a well visit for the first 6 months and then every other month until a year. We'll definitely be there for more than 7 well visits. Should we ask them to bill them as a sick visit?
I would ask. When I spoke with my insurance company, who was more helpful than the drs office honestly, they explained that its 7 well visits by law now between birth and 1 year and then its another 7 between 1 and 4. When DD was born we had a lot of weight checks and the drs office billed some of them as something other than well so that we'd have enough well visits and i remember from that time she had 11 for the year. 11 is a LOT more than 7.
Everyone should check with your insurance company and plan because I never had an issue with well visits and we def had more than 7 the first year.
|
| Posted 6/30/15 7:12 PM |
| |
|
SLPRunner
LIF Adult
Member since 12/13 1101 total posts
Name:
|
PSA - Well Visits
I have Oxford and have not had this issue.
|
| Posted 6/30/15 8:20 PM |
| |
|
jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
|
PSA - Well Visits
Are you on an exchange plan? That might be where the law is applied.
|
| Posted 6/30/15 8:35 PM |
| |
|
alli3131
Peanut is here!!!!!!
Member since 5/09 18388 total posts
Name:
Allison
|
Re: PSA - Well Visits
Posted by jessnbrian
Are you on an exchange plan? That might be where the law is applied.
And I'm guessing that the law is that insurance must cover at a minimum 7 visits the first year but anymore than that is if the plan wants to cover it. And each plan even with the same insurance plan can vary. Companies can pick and choose what they want included in their plan.
|
| Posted 6/30/15 9:02 PM |
| |
|
|
|
PSA - Well Visits
We had this but our Ped lowered the cost and we thankfully use flex spending
|
| Posted 6/30/15 10:32 PM |
| |
|
Jacksmommy
My love muffin!
Member since 1/07 5819 total posts
Name:
Liz
|
Re: PSA - Well Visits
I guess my dr does this since we go 7 times between 1-11 months (1-6 monthly then 9) and then at 12 months, 15 months, 18 months then yearly which is 7 between 1-4. I thought my older son went at 21 months and every 2 months between 6-11 but I am not sure now.
|
| Posted 7/1/15 5:22 AM |
| |
|
Tiggeruth
I am a mom :-)
Member since 6/06 3433 total posts
Name:
Heidi
|
Re: PSA - Well Visits
We have Empire and it was explained to me that some change happened between 2011 and 2014 about well visits. My Drs office has even reduced their number of well visits between how many my daughter had and now how many my son had.
|
| Posted 7/1/15 7:41 AM |
| |
|
Tiggeruth
I am a mom :-)
Member since 6/06 3433 total posts
Name:
Heidi
|
Re: PSA - Well Visits
Posted by Jacksmommy
I guess my dr does this since we go 7 times between 1-11 months (1-6 monthly then 9) and then at 12 months, 15 months, 18 months then yearly which is 7 between 1-4. I thought my older son went at 21 months and every 2 months between 6-11 but I am not sure now.
Your older son probably did go more often. I know my daughter went more than what is scheduled for my son.
|
| Posted 7/1/15 7:43 AM |
| |
|
MrsT809
LIF Adult
Member since 9/09 12167 total posts
Name:
|
Re: PSA - Well Visits
Posted by Tiggeruth
Posted by AliceCullen
Is this for all insurance companies?
My son goes every month for a well visit for the first 6 months and then every other month until a year. We'll definitely be there for more than 7 well visits. Should we ask them to bill them as a sick visit?
I would ask. When I spoke with my insurance company, who was more helpful than the drs office honestly, they explained that its 7 well visits by law now between birth and 1 year and then its another 7 between 1 and 4. When DD was born we had a lot of weight checks and the drs office billed some of them as something other than well so that we'd have enough well visits and i remember from that time she had 11 for the year. 11 is a LOT more than 7.
Weight checks for us were not considered a well visit and required a copay. I think typical well visits are within a few days of discharge, 2 weeks, 2 months, 4,6,9,12 months.
|
| Posted 7/1/15 11:33 AM |
| |
|
FirstMate
My lil cowboy
Member since 10/10 7790 total posts
Name:
|
Re: PSA - Well Visits
This must be new. I just took my newborn for his first well visit and there are signs posted and my ped made sure to mention it to me. I had no issues with DS1 4 years ago
|
| Posted 7/1/15 11:51 AM |
| |
|
Ian&EmmesMommy23
My family is complete!
Member since 11/08 12970 total posts
Name:
Diana
|
PSA - Well Visits
my insurance covers 7 visits...any visit outside of that i just pay the co-pay
|
| Posted 7/1/15 11:56 AM |
| |
|
Lillykat
going along for the ride...
Member since 5/05 16253 total posts
Name:
|
Re: PSA - Well Visits
I think it is policy determined. NYS probably requires they cover at least a certain number of visits, but some policies might cover more than that. When my kids were little different offices had different number of visits. One insurance we had covered all of them, then our insurance changed. The new one covered a lot but not as many. I had friends who founds many visits that were not covered. They probably put a number in place because the crummy plans did not pay for enough mandatory visits.
|
| Posted 7/2/15 6:13 AM |
| |
|
