We’ve all been there: You’ve made an appointment for your well-woman exam. You’ve received a breast and pelvic exam, Pap smear, and we’ve probably taken down your blood pressure and weight. At the end of your exam, we’ll ask you if you have any other questions or concerns. It seems like an open invitation to spill your guts, right?
You might be surprised to learn the answer is NO!
We can document – but not counsel or treat – concerns you have for future reference. But, it’s important to remember that anything your provider treats as a problem during your well-woman visit changes the visit to a problem-oriented one. And that can negate your well-woman benefits, causing both the exams to be applied to your deductible.
Here’s How It Works
Your healthcare insurance provides different coverage for preventive services than it does for problem-oriented or “sick” visits. Many insurance plans cover preventive well-woman exams without a copay. But, your provider is legally obligated to tell the insurance companies everything they discuss and treat during an exam. This is done through the CPT coding system that’s used nationwide, by every provider who accepts health insurance. A well-woman exam has one code; a problem-oriented or “sick” exam has a different one. As you can guess, that means both exams result in different charges for you.
So What Can You Ask About?
Here’s a list of topics that are perfectly fine to chat about during your well-woman visit:
- Refilling your birth control prescription
- Refilling your hormone prescription
- Testing for Sexually Transmitted Infections
- Cholesterol testing
- Getting the HPV vaccine
That’s it! Your well-woman exam is very quick and includes a breast, abdominal, and pelvic exam for preventive reasons. We may encourage you to get your colonoscopy or other maintenance exams with your Primary Care Physician, but other than that, we aren’t able to help with any problems without billing your insurance for a problem-oriented visit.
What To Address At A Separate Appointment
We want to help you with all your health concerns, but some topics that you think would be ok to bring up during a well-woman exam could mean a lot of money out of your pocket. The following concerns and problems should be addressed at a separate appointment:
- Breast tenderness
- Birth control options
- Cramps or other problems with your period
- Questions about sexually transmitted infections (STIs)
- Basic questions about fertility
- Concerns about heart health
- Weight loss plans
- Concerns about diabetes
- Depression or anxiety
- Fertility testing
- And more!
If there’s every any question about what’s ok to talk about during your well-woman exam, please ask us when you make your appointment. Our staff can be sure to set the correct appointment for you, thus minimizing many of the hassles that come with treating a well-woman exam like a problem-oriented one.