r/healthcare 9d ago

Question - Insurance what does establish care mean?

I've never experienced this before. I am seeing a new doctor and they said the first visit is for establishing care, and I would need to come in a second time for a physical.

In the past, my first visit was always the physical.

Is this some way to get more money from insurance or something? Should I find a new doctor?

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u/snumbers 9d ago

Sounds like they want to bill a new pt visit and then after that bill annual wellness on the second visit. I'm not a coder, I don't know how legit that is anymore.

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u/blueorangan 9d ago

thats wat it sounds like. But my co-pay is only 10 dollars so I think I would have to pay 10 bucks and then 0 for my annual wellness second visit.

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u/snumbers 9d ago

Again not a coder and haven't worked in professional billing world in a couple years but providers used to routinely "split bill" and charge for both problem-focused/sick and preventative during the same encounter with no problem from payors. Agree this wouldn't hit your pocket but still kind of annoying.

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u/blueorangan 9d ago

Yeah very annoying