Preventive vs. Problem Visits
What's covered by insurance?
Preventative/Wellness vs. Problem Visits
Primary Care Associates of Appleton follows standard healthcare billing practices and insurance rules for the type of care you receive.
Preventative/Wellness Visit
A preventative/wellness visit includes:
- Conducting an exam based on your age and gender.
- Providing advice about staying healthy and healthy living choices.
- Identifying risk factors and scheduling screening tests based on age, gender, or lifestyle.
- Keeping your immunizations up to date based on your age and gender. You may incur a cost if an immunization is administered.
Annual preventative/wellness visits are covered by many health insurance plans potentially with no out-of pocket costs to you.
Problem Visit
A standard office visit for a problem includes:
- Discussion of any new health problem, illness or injury.
- Management of chronic, ongoing health problems and/or medications.
Combine Your Visits - Preventative/Wellness + Problem Visit
If you are being seen for a preventative visit and you’d also like to discuss concerns not covered under preventative services, you have the option to do so. Please be aware that separate charges will apply. Federal law requires us to bill services for preventative care and problem visits separately.
Insurance coverage for combined visits is dependent on individual policy, but typically resembles guidelines under separate visits listed.
If you have questions about which services are covered in a routine preventative exam or a problem visit, please contact your healthcare insurance carrier. If you have questions about a bill you received from Primary Care Associates of Appleton, please contact our Patient Accounts Department at 920-996-1055.