Why can’t I bring up problems during a Physical?

Healthcare policies and changes are financially driven.

A few years back (probably around 4-5 years now) Medicare allowed for Preventative Screening visits. They still don’t believe a yearly physical exam is valuable (the actual examination of your physical body), but do believe screening tests are valuable and reduce the burden of disease later down the line. Those visits are only for preventative screening, which takes at least 30 minutes, and are covered by Medicare. Insurance companies followed suit with a twist (they usually follow Medicare’s changes). About 2 years ago, or so, with the initial rules of the Affordable Care Act, Insurance companies had to cover physical exams. In the past, patients used those visits to cover some of their concerns (and a good number of doctors allowed this). Well, Insurance companies were forced to cover physicals, but if the patient brought up any problems during that visit, they could not be included in the “preventative code” and they didn’t want to pay for this “free ride” that the patient was getting. So some instituted the concept that they only allowed for one visit per day. If we billed for a physical and problems, then that was considered two visits and they would only pay for one. Other insurance companies would allow it, but would discount the price and put it toward the patient’s deductible (which made for surprised and upset patients). After we took it on the chin for a month, losing money, we had to adjust our practice. So now you have to miss two days of work to accomplish what used to get done in one. With our direct care practice, you won’t have to anymore. We will take care of all your issues and the physical and give more time to do so – all on the same day. The care of the patient, not the bottom line of insurance CEO’s, should drive practice policies!

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