As of January 1, 2021 some significant changes were made by the Department of Health and Human Services to the national guidelines for billing medical office visits. Under the new protocols and regulations, if we manage a medical problem during a routine checkup, the provider is required to document and charge for this service in addition to the usual charge for the routine visit. You may be charged a copay or deductible when billed for a separate medical problem. Whether you are charged a copay or deductible depends on the medical insurance plan, and is determined by your insurance company, not by our office.
As an example, if your child is found to have an ear infection during a routine checkup, there will be a billing charge for the diagnosis and management of the ear infection in addition to the usual charge for the routine checkup. Another example, if your child has asthma and we discuss the state of your child's asthma and review the use of asthma medications during a checkup, there will be a separate billing charge for the diagnosis and management of the asthma issue. The same applies for children on various medications, injuries and other complex medical syndromes.
Please feel free to send us any questions via the patient portal regarding these changes or contact our billing department at 508-833-0269.