2021 Billing update
Did you know – if you are here for a well visit (physical appointment), you may still owe a copay?
We wanted to take a moment to inform you that as of January 1, 2021, some changes were made to the national guidelines for billing of medical office visits. One change in particular that we wish to describe to you is how billing for routine checkups will work under the new guidelines. Under these new guidelines, if we manage a medical problem, such as ADHD, asthma, diabetes, management of birth control or mental health concerns, we are required to document and charge for this service, in addition to the usual charge for the checkup itself.
For example, if it is discovered that your child has an ear infection during his or her routine checkup, there will be a charge for the diagnosis and management of the ear infection, in addition to the charge for the physical. Another example, if your child has asthma and we discuss how your child’s asthma is doing and review the use of his or her asthma medication during this physical, there will be a billing charge for the management of the asthma in addition to the normal charge for the physical.
While routine checkups generally do not involve copays or deductibles, a copay or deductible may be charged when billing for a separate medical problem occurs during a routine physical. A copay or deductible being billed to you depends on the medical insurance plan you have and is determined by your insurance company, not by our office.
If you have any questions about these charges or about a bill that you receive from our office, please contact our billing department.
The Providers of Plymouth Pediatric Associates