Kastler

This last part is not true. You may not understand medicine and why we order what we do. Large panels of physicians build guidelines. These provide algorithms for what needs to be done for certain conditions/symptoms. We will order what needs to be done and half the time insurance denies it for any convoluted reason that they can find. We can’t simply practice medicine any more. PLEASE don’t tell my patients to not mentioned symptoms. This whole system is fucked, but this is how critical information is missed. Everyone plays a part and I am just trying to do my god damn job and take care of the patient in the most appropriate way. Sometimes this means working with insurances to find what they will cover. I don’t know who you’ve worked with, but it seems that this is just part of the job now

I did not see mention of wellness visits. Regardless, if they have new issues, would it not be more expensive to have a wellness visit with nothing new and an office visit weeks later to talk about the new issue?

Yeah that is absurd. Is any of that type of thing at the discretion of the coder? I mean that is a normal thing to put in a note. The coder does not have to code for it. I get that some physicians/clinics etc. are actively looking for anything to bill, but there are many good clinics out there that don’t do that.

Right, this is why we are forced to work with insurances to find what works. It only takes one angry patient to know that particular piece isn’t covered and to have to go looking for what they require. As you mentioned, They change these constantly making the whole process frustrating for everyone

Exactly. This is what I was trying to convey in addition to what OP said since they are not technically medical. I’m a first year resident and was exposed to all these issues real quick. So much of this is our hand being forced to do thing we would not otherwise. We are the scapegoat and they get to bill higher. I’m sure some private practices do this but that is gonna be few and far between compared with the absurdity within hospital systems. I’ve bitched about this on many threads and the whole system in the us is so fucked that there really is no easy way to fix it.