New Preventative Care Benefits

For those who have had a health insurance policy issued later than 3/23/2010, effective 1/1/2011 your preventative care benefits are covered at 100% by your insurance company with no annual maximums.

Please click the below link for a list of services that the department of Health and Humana Services (HHS) deem covered.
http://bit.ly/9twrh5

Now, as of late...clients of the shoppe have been receiving bills from their insurance company for their recent routine annual checkup.  Depending on doctors, these visits can cost $150-$260 after insurance.  This is the amount that your Explanation of Benefits (EOB) states you may owe the provider.

When reviewing these EOB's, physicians are coding their claims as medical visits with all lab work being billed as diagnostic.  This leads to the insured receiving a bill for covered expenses.

If this is happens, you must call your provider and ask for them to resubmit claims under the right coding and must include medical records for that day of service.

If you have not had your annual checkup...make sure to notify the providers office to code claims as preventative or routine.

Please feel free to contact the shoppe with any questions on this.

Thanks,

Jordan