# Preventive visits?



## veloso (Aug 12, 2011)

Hello to All,
I have been told that some COMMERCIAL INSURANCES will pay PREVENTIVE VISITS more than ONCE A YEAR for example CIGNA their PRACTICE got PAID-TWICE PER YEAR-.
To my understanding these PREVENTIVE VISITS CAN ONLY BE USED-ONCE A YEAR- and if so that this is the case where could I get these GUIDELINES?

HELP!!!


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## Deb2009 (Aug 12, 2011)

You would have to query each insurance company.  Not sure that a preventative visit would be appropriate more then once per year.  The second would be an E/M follow-up visit.   Just thinking???


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## btadlock1 (Aug 12, 2011)

veloso said:


> Hello to All,
> I have been told that some COMMERCIAL INSURANCES will pay PREVENTIVE VISITS more than ONCE A YEAR for example CIGNA their PRACTICE got PAID-TWICE PER YEAR-.
> To my understanding these PREVENTIVE VISITS CAN ONLY BE USED-ONCE A YEAR- and if so that this is the case where could I get these GUIDELINES?
> 
> HELP!!!



See: https://s-secure.cigna.com/portal/healthcare/pdf/807467bPrevGuidelines.pdf


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## rthames052006 (Aug 12, 2011)

*Well child or well adult*



btadlock1 said:


> See: https://s-secure.cigna.com/portal/healthcare/pdf/807467bPrevGuidelines.pdf



I just had a thought... Are we talking well child visits or well adult visits.  I know well child visits from birth to a certain age a child is to have several based on a schedule.


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## btadlock1 (Aug 12, 2011)

rthames052006 said:


> I just had a thought... Are we talking well child visits or well adult visits.  I know well child visits from birth to a certain age a child is to have several based on a schedule.



There's always the possibility that the people who got paid for multiple visits had coded their claims incorrectly, too. I wouldn't trust anything that I didn't see with my own two eyes...


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## cmranvik (Aug 12, 2011)

I work for a health insurance company, and we have situations where we allow two preventive exams per year.  Our commercial products allow females one general routine exam and one routine gyn exam per calendar year, and there is no limit on preventive exams for children under the age of two.  As stated in the previous posting, you should check with the insurance company.  Preventive care guidelines for insurance companies have changed with the passage of health care reform.


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## veloso (Aug 12, 2011)

A BIG THANKS TO ALL;

 But is there a specific website that I could go. I'm a Medical Coder in an Adult Clinic and I worked as part-time for an Adult and Pediatrics as a Medical Coder and as a Medical Biller as well...
IM


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## veloso (Aug 12, 2011)

A Big Thanks to ALL;
But is there a website where I could go and by way I'm a Medical Coder in an Adult Clinic and I'm a Medical Coder and Biller in an Adult and Pediatrics as well.

IM


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