Beware tacked-on fees at doctor visits
To the Editor:
Every fall I schedule a routine physical (“wellness visit”) with my primary care provider (PCP).
I wanted to share an experience that came up last year. I have had the same PCP, same carrier, and same coverage for more than a decade. My wellness visit has always been covered 100 percent.
Last year after my visit I received a bill from my PCP for $11.50. I work in a health care field and am very well-versed in how my benefits work, so I called my carrier to question why this was not 100 percent covered. The carrier indicated it has become common practice for PCPs to code a behavioral health assessment with your routine physical —which is not covered as part of my wellness visit.
If your PCP asks you anything along the line of how you are feeling — happy, sad, depressed — they can charge an additional fee. I did some research and found that physicians are using this to generate additional revenue for their practice.
I contacted my PCP and advised them I had not asked for this type of care during that appointment. My employer even offers a free employee assistance program (EAP)—so I would not have ever went to my PCP for that care, if needed.
They did end up removing the $11.50 from my account. Your PCP should be required to inform you that they would like to ask some behavioral health questions and that the service may/may not be covered by your insurance provider.