James R Hoppe MD and Ngoc Tran-Hoppe MD
273 Durham Ave
South Plainfield NJ 07080
phone: 908-561-9900
fax: 908-561-6650
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REGARDING ANNUAL WELLNESS VISITS
 
Since Obamacare introduced free annual wellness exams (no copay), there has been a general misconception about what is included in this exam. Please see the below excerpt taken from the Obamacare website:
 
“This is Preventive Care: Preventive care focuses on evaluating your current health status when you are symptom free. Preventive care allows you to obtain early diagnosis and treatment, to help avoid more serious health problems. Through a preventive exam and routine health screenings, your doctor can determine your current health status and detect early warning signs of more serious problems. Your preventive care services may include immunizations, physical exams, lab work and x-rays. During your preventive visit your doctor will determine what tests or health screenings are right for you based on many factors such as your age, gender, overall health status, personal health history and your current health condition.
 
This isn’t Preventive Care: Medical treatment for specific health conditions, on-going care, lab or other tests necessary to manage or treat a medical issue or health condition are considered diagnostic care or treatment, not preventive care.”
 
Source: https://obamacarefacts.com/obamacare-preventive-care/
 
These are the guidelines that insurance companies use and guides our billing practices. If we review and treat any acute or chronic issues this does not fall into the scope of the annual wellness visit and you will be responsible for a copay. If you do not want to be billed for a copay then we need to stick strictly to the preventive care issues at the visit and you would need to schedule a separate visit to go over any symptoms, concerns, or chronic conditions.


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