The services provided as part of a well-child or adult annual checkup are generally defined by the health insurance company. These checkups include an assessment of growth and development, screening for medical and psychosocial problems, anticipatory guidance to aid you in knowing what is ahead in the life cycle, or in the next stage of your child’s development. We review vaccination history and status and administer vaccines when necessary. We are happy to address questions that come up during the visit- many can be answered simply and fall within the scope of a well child checkup or adult physical.
Preventive exams are an opportunity to discuss the big picture, to screen for mental and physical concerns and dive into any obstacles to your wellness.
Sometimes, a more significant health problem will be identified over the course of this visit, or treatment is requested during a preventive exam. If so, the time and effort spent addressing these concerns go beyond the scope of what is covered by a well-child or adult preventive exam. Some examples include:
When one of these scenarios arises, your doctor will typically submit billing codes for both a preventive visit and a “modifier” that indicates that an illness or problem was treated in the same visit. This is standard billing practice among all primary care providers and is accepted as standard practice by government agencies and by private health insurers. While most plans cover preventive care in full with no co-pay, there is often a co-pay, co-insurance or deductible associated with the “modifier” billing codes. If our receptionist didn't know during check in that there would be a double-visit and you don't have a card on file, you will receive a bill for services after your insurance has paid.
Whenever possible, we recommend you schedule a separate visit to treat new or chronic medical conditions.
One Sky Family Medicine
6327 22nd AVE NE, Seattle WA 98115
phone 206-363-5555 fax 206-363-5533
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