When an Annual Physical is not an Annual Physical...

[Squirrell34]

I'm really torn about what to do with this.  But I'm really irate right now.

I have been going to the same Family Practice for 6 years.  They took care of me when I was pregnant with my son, and at the time I thought they did a great job.  Until I looked back after my delivery, and felt like they really overlooked some things and made my recovery & birthing experience pretty lousy.  They were also really slow on the get-go to get my son's tongue tie cleared up.

I've also had some issues with particular residents, but I've chalked that up to the residents just being crummy, and have avoided them since then.

My latest problem is with billing.  And I think this is the final straw.
My first prenatal visit was in July.  At this visit, we didn't get to hear the heartbeat, or get measured or anything.  I just got my annual physical and left.  I was due for my annual physical, so thought nothing of it.  I always get mine in July or August, around my birthday.

Well, I get the bill.  I get to pay for all the tests & lab fees.  Why?  Because my healthcare plan only covers wellness physicals.  Because the doctor's office billed it as a Pregnancy physical, not an Annual physical, the insurance company won't pay. 

The insurance company can't pay unless the doctor changes the billing code to "annual" not "pregnant".  And since I'm technically pregnant, she won't change it.  Even though whether I was knocked up or not, I'd still have gotten the exam in July or August.  I know rules are rules, but this is a pretty stupid one in my book.  So I'm out about $200 bucks.

I'm so livid I'm tempted to change to a different hospital.  I have to see if the one that is smaller, but equally close is able to do VBAC procedures.  If so I may be swapping.  We'll have to see.

Anyone else think it's OK to be a little frustrated at this point?  Please don't turn this into a healthcare debate -- yes the system's broke -- I know.

[manders018]

Aug. 31, 2009 at 12:31 PM

Yes you are allowed to be frustrated. AND you are allowed to yell if you want to about it.

[LoveMyDog]

Aug. 31, 2009 at 4:03 PM

I change Pediatricians when they billed my youngest's 2 month or 4 month check up under my then 13 year old daughter.  Surprise the insurance company didn't pay.  So when I called and had them bill it under the right child and then insurance did pay.  They didn't take the charges off of my daughter's chart though.  That on top of bad parenting advise from a young doctor whose wife does all the real parenting and I was out of there finally. Oh and the broken thermometer mercury that wasn't handled as hazardous waste.  And the the 2 week wait to take my daughter to the only female doctor in the group then she was over booked so we got to see one of the men anyway.  I should never have stayed with them as long as I did.  Don't stay where there is no professionalism or logic.

[mmmegan38]

Aug. 31, 2009 at 6:56 PM

  Well why are you going to family practice when your pregnant? What about an ob/gyn? That is who I saw when I was pregnant. Don't you have another doc. for pediatrician? My kids doctor is different than mine.

  Yeah be annoyed, too many hassles and find a better one. I usually ask my friends who they like then why do you like them. It is hard to shop for a doctor. Do it now not later.

[Tigger013169]

Aug. 31, 2009 at 10:28 PM

You have the right to be frustrated. They could have given you a break. I know with us, we had a dr that wouldn't even look at our baby son when he was running a high fever because we owed them money!! Then another dr in the practice said we were nickle and diming him by asking about my older son's aches and pains. I wanted to put an end to the whining if it wasn't real. Then we moved unexpected out of state because my husband lost his job, we had the new dr send a request for the kids' records, they wouldn't send them so the babies got behind on their shots!!! I never went back when we ended up moving back there. Don't wait, if it doesn't feel right to you, it isn't worth it!!