I received a bill of $25 from my primary care office For my yearly physical. I checked the breakdown on the billing of my insurance and they billed it as two visits – one for the physical and the other was billed as an outpatient visit.

I called billing and asked what that was all about and they asked me if we spoke about any other health issues at the time. I told them I had asked if I needed a referral to see the urologist and they said yes they could send one over – no exam performed.

Billing tells me that’s why it was billed as such and they needed to bill it that way due to “being audited by the insurance company.” I called my insurance company (blue cross blue shield) and they told me they can bill it like that but it’s at their discretion.

PCP called back and told them to call my insurance company to tell them how unhappy I am with the rule so I tell them I already did and they told me it’s at their discretion and I was told that’s absolutely wrong by my PCP.

Any idea who is correct and how this is allowable for wellness visit? I asked my pcp office if I just shouldn’t speak at my next one and was told “yes.” Seems crazy to be charged $25 for a referral? Not sure if they’d give me one without an appointment if I called over the phone

submitted by /u/NoRelationship4258

See also  Bill would fine Oklahoma health insurance companies that do not pay claims - The Center Square