A few weeks ago I went to my PC doc for a referral to a urologist for a orchiectomy.  I see him this week but today a got a bill from the PC provider with this coding: Offic/outpt visit E&M EST LOW-MOD
Hopefully there are some medical professionals here who can explain what that means and why they charged me $111.  Usually I just pay the $25 copay and that's that. 

Office/Outpatient visit; Examination and Medication; Established patient (not a walk in/new patient with no history);  Low/Moderate Risk Level.

Not sure why insurance didn't cover unless they don't have contract with the provider or the provider screwed up and didn't note referral to insurance which throws a "Primary care provider did not order services" flag.

You might have a limited number of "well" visits per year.
Check your policy or call them and ask.

Quote from: Flan on April 30, 2014, 05:42:09 AM
Office/Outpatient visit; Examination and Medication; Established patient (not a walk in/new patient with no history);  Low/Moderate Risk Level.

Not sure why insurance didn't cover unless they don't have contract with the provider or the provider screwed up and didn't note referral to insurance which throws a "Primary care provider did not order services" flag.

Thank you for interpreting that.  Now it makes sense.  Not sure why they sent me a bill but I'll check into it.

Quote from: KarinMcD on April 30, 2014, 10:49:08 AM
You might have a limited number of "well" visits per year.
Check your policy or call them and ask.

Maybe but I've only had two or three visits this year.