Did my new primary care physician code our visit correctly?
Hi all, dumb questions incoming probably. You can be brutal if you want, maybe I deserve it.
California, employer provided HDHP for the first time because I got LASIK this year.
New plan, so new PCP—wanted to make sure I was on top of whatever standard medical upkeep. My plan says "If you visit a health care provider’s office or clinic… Preventive care/screening/immunization… No charge. Deductible does not apply."
So I went out and found one. In the appointment reservation, I honestly don't remember —I may have put down some things that were ailing me, but I wasn't really looking for a visit for those reasons and didn't expect solutions, and didn't get any in any case. But if your doctor asks, you tell them if you have problems and don't keep things from them, right?
If I didn't mention them there, then I definitely mentioned them in the visit. As far as I can remember there were three. Bad back for half a year that seems to be getting better since I put an extra layer in my mattress ('see if it goes away on its own'); numbness in thumb for two months, maybe ergonomic injury (same, 'nothing we really do for that'), and then one I definitely didn't put down on the appointment reso—small occasional blood on stool. We talked a little bit about it without any real advice, then she referred me to a gastro. She then asked when was the last time I had my blood levels checked, and I said IDK, so she said let's do that.
A few weeks later and I have $1600 in bills. $700 is the visit, which has been coded "diagnostic" and applicable to my deductible in full. I pay $100 of it. $900 is the labs, which hasn't been coded yet. Questions: Will I pay for the labs too? How much, probably? Did I eff up here? Should I have just kept the non-preventative stuff to myself? I suppose I don't see a general blood panel on this list of preventative services. Is it not? Will an HDHP not cover this? Is there no point in asking provider to recode?
I did go to the gastro referral because I figured the referral during a preventative visit made it covered, but I am pretty satisfied that I got that one very wrong and will be charged for that too, who knows how much. He wants to do a colonoscopy, which is both diagnostic and under 45, so that's not preventative and not covered either, so no. Is that normal to go straight from "there's a small amount of blood on, never in, my stool a few times a month with no other symptoms, and I can feel that it's right at the end of the tract" to "full colonoscopy" in a 35yo? That seems dramatic, no…? That's also been there for a half a year, so if it is reasonable, I will give it another shot in November.
I don't know man. I'm probably just blundering this all up—was on Medicaid before this, which was the polar opposite haha. Time to learn I guess! Never been in a situation in or out of healthcare where people say "you should have this" without speaking up if that part of the visit costs anything, let alone what that cost is. I don't like it! Will definitely be switching to HMO during open enrollment in November. About to eat up all my savings on premiums over a few minutes of banter. Ug.
submitted by /u/Mojojojo3030
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