We treat a number of illness and diseases. Newborn, childhood and adolescent.
Newborn to two years old checkups, vaccinations, circumcision, growth chart
Cough/Cold or the Flu, Ear Ache or Rash, Bug Bite or a Fall
Annual checkups, Vaccinations, HVP, smoking and drugs,Camp or Sports Physicals
WE HAVE ADDED TELEHEALTH VISITS IN RESPONSE TO THE COVID-19 OUTBREAK FOR CURRENT SICK PATIENTS OR PATIENTS THAT CAN NOT COME IN. PLEASE CALL THE OFFICE FOR MORE INFORMATION.
UNDERSTANDING THE TYPES OF VISITS AND INSURANCE POLICIES
Wellness Exam, Physical, Chronic Care, New Symptom (Sick) Visit… If you’re confused about the differences among these terms, you’re not alone. The services performed at each of these visits are distinct. And deductibles, copays and coinsurance vary depending on the type of insurance you have. At Maian Pediatric, our goal is to help you understand the different types of office visits we offer so you know what to expect. Below are descriptions of each one with the details of the services provided and what insurance may or may not cover. These are general guidelines only. Your insurance company’s coverage might be different, and it’s important to know your benefits prior to scheduling an appointment. We encourage you to familiarize yourself with what your insurance plan offers. Visit your insurance company’s website for details.
Well Child Exam
An exam on a healthy child with no symptoms to look for hidden disease and give advice on healthy behavior. Getting the right preventive services at the right time can help your child stay healthy by preventing disease or by detecting a health problem at an early stage when it may be easier to treat.
Does Not Include: Medication refills, evaluation of new symptoms, or management of chronic problems.
Insurance Coverage: Covered by most insurance companies. However, if new medical issues are discussed or chronic problems are managed, there may be an office visit charge. Check your policy for frequency limitations. Copay, deducible and coinsurance may be applied.
Sick Child Visit
An appointment to investigate a new symptom such as cough/cold, ear ache, rash Oftentimes, the problem is quite simple, or may require diagnostic tests and follow- up visits.
Does Not Include: Medication refills for other problems or review of preventive services.
Insurance Coverage: Covered by almost all insurance companies. Copay, deductibles and coinsurance may be applied.
Camp physicals, school physicals, work physicals, insurance physicals—this type of visit requires the doctor to complete a form. Services include whatever is necessary to complete the form.
Does Not Include: Medication refills or evaluation of new problems.
Insurance Coverage: Sometimes covered by insurance, but often not. In cases where a form is needed a short time after an appointment (i.e. child had an annual Well Child Exam to update immunizations and three months later needs a form filled out for camp, the doctor may be able to complete the form without another visit. However, there is a fee to fill out the form and that fee is usually not covered by insurance.
Coding for Your Insurance
The difference between medical services is sometimes hard to understand. Our reimbursement is based on the coding system that insurance companies use to describe medical work. You may have had one visit with
two services given. If the child has a well visit and treated for ear infection with the well visit, the decision-making for treatment is not just writing a prescription. The annual checkup and the evaluation and management for the ear infection are billed as two separate services.
To help you to understand this, think of work done on your car: If you have insurance coverage for your vehicle due to an accident and you bring it in, that’s covered. However, if you also asked for an oil change and service while you had it in the shop, you would have to pay the additional fees for the added services received.
Visit Our Secure Patient Portal
Electronic Medical Records is now the norm in Health Care. You can complete your intake forms, view your records, update your information all in one place.