Wiki well checks the first year

[lngast]

Question from my doc: How many well checks can I do the first year? Babies usually come in at 3-5 days old, 2 weeks, 1 month, 2,4,6,9, and 12 months. Do I do private and Medicaid differently since there are no 1-month vaccines given for Medicaid? Also, if they have Medicaid secondary, can I do the Medicaid well check which covers vision and hearing since private pay does not cover vision/hearing?

 

[KGETGEN]

The number of visits may depend on payer policy; however, I have noticed a lot of insurances (in NY) do follow 6 well visits (99391) within the 1st year of life (<12mo old). The office I work for does a jaundice/weight check for the 1st visit (3-5days old) and then preventive visits at 2weeks, 1mo, 2,4,6,9. We then bill for the 12mo,15mo,18mo and 2yr under 99392.

Vaccines: We give the #2 Hep B vaccine at the 1 month well visit, given the patient receives it 28 days after the 1st dose.

Vision/Hearing: Most private insurances (for us) pay for the vision and hearing while Medicaid does not. As long as the private payer deemed it patient responsibility you could bill it to Medicaid for reimbursement, otherwise you would accept assign. We bill all well visits the same no matter what insurance the patient has as we follow the AAP guidelines for preventive visits. https://www.aap.org/en-us/Documents/periodicity_schedule.pdf

Hope this helps.

 

[Cynthia Hughes]

Well checks

Question from my doc: How many well checks can I do the first year? Babies usually come in at 3-5 days old, 2 weeks, 1 month, 2,4,6,9, and 12 months. Do I do private and Medicaid differently since there are no 1-month vaccines given for Medicaid? Also, if they have Medicaid secondary, can I do the Medicaid well check which covers vision and hearing since private pay does not cover vision/hearing?

Payers who are subject to the preventive care benefits under ACA will cover the well-child visits according the Bright Futures recommendations. See https://www.aap.org/en-us/professional-resources/practice-support/Pages/PeriodicitySchedule.aspx for more information.