What is a wellness exam?

Your annual exam is a comprehensive exam focused on preventative (accessing for problems before they start or get bad) with your primary care provider. An annual exam does not include discussion of new problems and may only briefly review chronic conditions. Annual exams may also be called routine check-ups, yearly exams, an annual pap, or preventive visit.

Will my insurance pay for a wellness exam?

Most health plans will pay for one wellness or preventative exam per year. Your insurance provider may consider this to be once per calendar year or one year and one day since the date of your last wellness exam. This would include a well-woman exam or annual pap smear. Basic labs are included with your visit (except medicare) but specific testing may not be paid by your plan. We make every effort to let you know if there may be an additional charge but every plan is different. It is the patient’s responsibility to check with their insurance provider to see what is covered under their wellness benefit and to ensure they are eligible prior to scheduling their annual wellness exam.

What is the difference between a wellness exam and a problem visit?

Preventative visits and tests ordered by your provider can help you stay healthy and catch problems early. Problem (or diagnostic) visits and testing are used to diagnose a current health problem. Diagnostic tests are ordered by your provider when you have symptoms and they want to find out why. For example, checking blood sugar because you have a family history of diabetes is a preventative screening, but if the test is ordered because you are having symptoms of high blood sugar, this is considered diagnostic.

Can I have a wellness exam and problem visit at the same time?

No. Billing issues prevent your us from doing a wellness exam and a diagnostic visit on the same day. This is for your protection as your insurance carrier may deny one of these visits and pass the cost to you. This does not prevent you from asking a simple question or requesting refills of any maintenance medications; however, we ask that you please schedule a separate appointment, on a different day, if you have any new concerns or other ongoing health problems that need more attention. Should your wellness exam turn into a diagnostic or problem-oriented visit we will bill accordingly.