There are many reasons why a person may wish to see a San Diego family doctor and you should know what each visit entails. The service you receive from a “check up” is different than the procedures in a “chronic care visit”. Not only is the medical examination different, there are also financial consequences in the form of health insurance deductibles and co-pays. Here at Associates in Family Medicine, we wish to clarify the different types of doctor’s visits you may have.
Physicals, Check Up, & Wellness Visits
- What it is for: A wellness examination is one done on a person who has no symptoms of disease and who has healthy behavior. This type of doctor’s visit is for preventive care: we use this time to keep you healthy and to detect health problems (if any exist) at an early stage.
- Does not include: Wellness exams do not include: medication refills, evaluation of new symptoms, or management of chronic problems.
- Insurance Coverage: Wellness checks are covered by most insurance plans.
Follow Up/Chronic Care Visit
- What it is for: This type of visit if for reviewing chronic problems, adjust medications, check laboratory monitoring, or refill prescriptions. For some simple chronic problems (example: allergies), this may be once a year. For more significant problems, it may be at least twice a year.
- Does not include: This type of doctor’s visit does not include preventive services.
- Insurance Coverage: Covered by almost all insurance, including Medicare and Medicaid.
New Problem/Symptom Visit
- What it is for: This type of visit is for evaluating a new symptom (examples: chest pain, unexplained weight loss, depression). Oftentimes, the problem can be complex with multiple symptoms and require diagnostic tests and follow-up visits.
- Does not include: New problem visits do not include medical refills and preventive care services.
- Insurance Coverage: Covered by most insurance, including Medicare and Medicaid.
Administrative Physicals
- What it is for: This type of visit is primarily for doctors to fill up forms needed for camp physicals, school physicals, work physicals, and/or insurance physicals. Services provided during this visit is geared towards filling out the forms.
- Does not include: Administrative visits do not include medication refills or evaluation of new problems.
- Insurance Coverage: These may be covered by insurance, but often not. In some cases (example: a short period of time elapsed since a previous visit), the doctor may be able to complete the form without another appointment. At other times, there is a fee to fill out the forms and that fee is usually not covered by insurance.
“Welcome to Medicare” and Annual Medicare Wellness Visit
- What it is for: This is a special planning visit to review which Medicare preventive services you need. Medicare requires that a standard set of questions be asked. They must include: review of functional status, depression screening, list of special medical equipment (if any), and list of other doctors. At the end of the visit, you receive a written summary of the services you require that are covered by Medicare. These might include cancer screening tests, EKG, blood tests, bone density tests, ultrasound, etc.
- Does Not Include: Medication refills or evaluation of new symptoms.
- Insurance Coverage: Medicare pays in full. There is no co-pay or deductible.
Additional Concerns
How Much Will This Cost?
Different medical services have different price tags. Sometimes it can be difficult to determine if you are seeing the doctor for a new symptom or if it is an extension of an existing condition. Associates in Family Medicine does not control how these visits are categorized: the insurance plans have a coding system describing different medical procedures. For example, a visit to the doctor’s office to refill a prescription has a different code (and different price) compared to a visit for a physical examination.
Can I Combine Services?
For your convenience, it may be possible to combine two or more types of service within one doctor’s visit. For example, you can come in for a wellness check, and at the same time, have a prescription refilled. However, this will depend on what your visit is for, how severe the condition is, and what types of equipment is needed for the visit. Depending on your insurance benefits, we may collect two co-pays and submit two charges; it is, after all, two services combined at one time slot.
Which Condition is Most Important?
Dr Michelle Hamidi relies on your personal medical history in combination with any current problems to focus in on what’s important. Your symptoms will be evaluated with your medical history in mind. thus it is important to tell your doctor what previous conditions you have so that she can make an accurate diagnosis of your current symptoms.
What Tests/Services Should I Get?
Providers are specially trained to evaluate the usefulness of tests and preventive services and help you decide which ones are right for you. We offer advice on immunizations, X- rays, blood tests, and a host of other special procedures. Generally, testing is based on your age, health history, and risk factors. We rely on information from the United States Preventive Services Task Force to guide our recommendations.
Please Contact us if you have further questions regarding your doctor’s visit.
