As you may know, most insurance companies have very specific regulations about billing for health care services. As your healthcare providers, we are required to follow those regulations in how we report services provided to you. All physicians/providers must report to the insurance company in a universal code system that is linked to the service, treatment or procedure that was provided.

It is not uncommon for patients in the course of one visit to receive care in both the form of a regular check-up and evaluation of an acute or chronic illness. For example, a child being seen for a well-child physical exam may also that day present with fever and ear pain. The child is evaluated and treated for an ear infection as well as examined for his well-child physical. Both services must be reported to the insurance company. As another example, a child with asthma may have his/her asthma evaluated at the same time as the well-child physical exam. Again, both services must be reported to the insurance company.

Insurance companies handle these reported codes differently. Some insurance companies may require an additional co-pay or charge; this is determined entirely by your insurance company. If you have questions, please check with you specific insurance company.

As always, we are dedicated to providing the best possible care for you and your family. If our business office can help, please contact them at 919-942-4173 x118.