We spend lots of effort to educate patients using handouts, mailers, and an electronic sign in the waiting room that a routine physical is just that... a routine wellness check. A number of our patients have a "wellness option" in their insurance, which for us pays fairly well. We review health issues, PHFSH, vaccination status, risky behavior, etc. with a goal of outlining what needs to be investigated further. It is then billed as V70.0 and coded as 99396. We are very clear that this does not include treatment services, prescription writing, labs beyond routine labs, etc. If a patient wants to discuss problems, engage in diagnostic services, or other treatment issues then they are told they will need to make an appointment for diagnostic and therapeutic services, as their insurance does not consider this part of a wellness visit. This future visit will then be billed at whatever level is appropriate. With enough "front end" warning, we do not get that much pushback.
