PCP included non-preventive bloodwork with the preventive blood work during wellness visit without my knowledge. Now the office is billing for a comprehensive office visit instead of a free wellness visit.

This is infuriating and my last straw on the bait and switch "free" preventive exam.

The issue is that they were only supposed to order preventive blood work. Instead, she included tests for vitamin d, uric acid and TSH, all of which are not considered preventive. I do have gout and I was treated for a vitamin d deficiency last year. I don't have a thyroid condition, but sources say TSH tests are not preventive, so I don't know why it was ordered. However, I never asked for these tests as I knew it would complicate the coding for the preventive exam.

We didn't discuss either of these conditions during the visit, she just threw them on the order without my knowledge and I was none to the wiser until I got bill and reviewed the visit summary. In the summary and claim to my insurance, she added other diagnostic conditions, saying we discussed other chronic issues or already resolved preexisting conditions that she pulled from previous records. We never discussed any of these though.

I never even got the blood drawn as they were unavailable to do it that day. Regardless, because she wrote the orders for the tests, her records are justifying that this was a diagnostic visit.

The office is also trying to bill me as a new patient since my doctor changed practices since last time I saw her last year. All the sources I've read state this is improper, that I am still an established patient. However, this new office states it's their office policy to bill this way. They are also refusing to say a wellness visit was conducted and stated the reason for the visit was to establish myself with a new PCP and to have my uric acid and vitamin d checked, both lies.

I also contacted the insurance for help. They say there's nothing they can do as the visit was covered and they said they do not validate the truthfulness of the claim, they only review based on what they receive. They said I could appeal, but the appeal will not go anywhere as they will just reevaluate the same claim on how it was coded and how it was coded says it's an office visit.

submitted by /u/OkDish4406
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