Took my 15 year old daughter for her annual Well Child/physical. My wife normally takes her, but she was busy that day....daughter didnt want me going back to room for exam, understandable. Took all of 10 minutes and then left. Fast forward to today, got bill, Dr. billed on top of annual physical for "CPT 99213 Office out pt E&M Estab", called up clinic to ask what this was for and apparently my daughter talked to Dr about excessive sweating and Dr. referred her to a dermatologist if daughter wanted help with that issue.

After discussing with clinic rep said she will consult with supervisor and get back to me, but can they legally add another service for a minor w/o parent being present on top of what initial appointment was for?

jsc8116 said:

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After discussing with clinic rep said she will consult with supervisor and get back to me, but can they legally add another service for a minor w/o parent being present on top of what initial appointment was for?

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Not sure about that, but technically when you bring up a specific problem, it no long becomes a routine annual physical/preventative medicine appointment.

Even if you were in the room, I suspect you wouldn't have objected to your daughter bringing up the issue?

Some docs will let it slide, but with insurance cutting reimbursement rates, and nickel and diming the clinics over petty things, there's a lot of pressure on clinicians to document and bill for everything that occurs - similar to how a lawyer may bill by the minute.

As kiddoc said, yes it's legal. In fact, technically, it's illegal NOT to bill that. Legally drs are legally bound to bill accurately, cannot over or under bill

I had this happen. Went to a new doctor for a physical. He asked me if I had any health issues and I told him I was on blood pressure medicine. Got a bill for a regular office visit (consult for hypertension) and also was charged for blood work (that was supposed to be free). I called several times and the POS would not talk to me or call me back. That was complete fraud and a violation of the deceptive trade practices act. I told everyone I knew about this, so hopefully it cost him more in reputation and future business.