“I thought preventive care was covered at 100%. Why did I get a bill?”
A distraught employee is in your office because they’ve received a bill after their annual physical. You’ve encouraged and incentivized your employees to receive preventive care because you know that these visits can positively impact the onset and severity of chronic diseases. Now, the employee is frustrated and confused and looking to you for an explanation.
If your employee received a bill after a preventive screening, three things could have happened:
They didn’t see an in-network provider
Members can locate an in-network provider by using the Find A Doctor tool.
They talked about a health issue that isn’t considered preventive
The doctor or patient may have asked additional questions that lead to additional testing. What’s included in the benefit? Check out our Summary of Preventative Care resource.
They received a service that wasn’t considered preventive
Learn what services, what age and how often employees should be receiving screenings here.
In truth, the best way to avoid unplanned costs is to equip employees to be savvy health care consumers. This requires proper benefit education and understanding.
These tips will help avoid extra costs during preventive visits
Be clear when schedulingEnsure the provider knows that you are scheduling a preventive care visit, which is covered at 100% by your plan.
Advocate for transparency
Ask if any tests or treatments done during your appointment might not be considered preventive care.
Don’t get off track
Ask if talking about other health problems that are not considered preventive care during your appointment will lead to extra costs. If so, schedule a follow-up visit.
Know it doesn’t end at this doctor’s office
Ask if lab work can be sent to a Blue Cross NC in-network lab to lower your costs.
* This is representative of ACA-compliant (non-grandfathered) benefit information.