During a Preventative Exam, or Well Woman Exam, the focus is on routine health maintenance. You and your physician will discuss your medical history and do a full exam which usually includes a breast and pelvic exam. In addition, your physician may recommend screening tests (i.e. screening mammography), help you develop a risk factor reduction strategy (i.e. smoking cessation), and create a plan to promote a healthy lifestyle. This preventative visit is not intended to be a problem-based or follow-up visit.
If you have additional concerns, and for convenience sake you wish to address these in a single visit, ask your provider if there is sufficient time to do so. Evaluation and management of additional chronic health problems or acute medical issues will likely incur additional service charge(s) or may require a separate visit (i.e. pelvic pain, abnormal bleeding, osteoporosis, decreased libido or infections). Please see below for further explanation.
Understanding Billing and Insurance Coverage
We bill for our services according to nationally recognized standards. For compliance purposes, we do so without regard to a patient’s insurance coverage and we will not alter charges or diagnoses in order for services to be covered or paid by a patient’s insurance plan as this would violate our contracts with your insurance carriers.
If testing ordered by your physician is done for a specific diagnosis rather than screening, it will most likely not be covered by your preventative coverage benefits, meaning you may be responsible for part or all of that cost. This does not mean that services were denied by your insurance, rather, they were allowed, but applied to your deductible or co-insurance according to your plan benefits