Billing for acute visits on top of wellness visits

Billing for Problem/Sick Visits On Top of Wellness Visits

For a decade or more now the Center for Medicare Services has required us to bill for an additional problem/sick visit on top of a wellness visit if we put any significant time or effort into an acute or chronic problem.  At Lakeside Pediatrics, we have rarely done this because we haven’t wanted families to get unexpected bills.  For maybe half of our wellness visits, there have been other problems managed for which we have not charged.

There are problems with this approach.  First, we are not accurately charging insurance companies for what we are doing, which encourages them to take advantage of us.  Second, we bring in much less money.  Profit is honestly something we think about very little.  What we do think about a lot, is being able to pay our staff in ways that are comparable to what the hospital pays.  We worry about the cost of living going up and wanting to support our staff.  We worry that our staff are overworked because the demands on them are more than they were in the past, and we can’t afford to hire more employees.

So, in the spirit of keeping this practice healthy so that we can best serve you, we will now be charging for sick/problem visits on top of wellness visits.  If this causes a financial hardship for you, please call us to discuss it.  Thank you for understanding.