Preventive care is defined as routine care in the absence of symptoms or known disease. Has been referred to as an “Annual Physical”, “Complete Physical” or “Well Child Check”. The extent and focus of the services can depend on the age of the patient. Services that may be considered preventive care can include the following:
- Review and updating past medical and family history*
- Evaluation of risk factors such as smoking and alcohol use*
- Periodic physical examination*
- Glucose testing to screen for diabetes
- Cholesterol screening
- Colon cancer screening (colonoscopy)
- Routine vaccinations (tetanus, influenza, childhood vaccination series)*
- Bone Density testing
- Prostate screening
- HIV screening
- Chlamydia/Gonorrhea testing
- Pap Smear
- Mammogram for women
- Reviewing stable, established problems and renewing medications that do not require changes. *
- *Well-Child Checks- Issues typically reviewed during exam dependent on age
- Preventive Care does not include the following:
Evaluation of new symptoms
- Testing for a new diagnosis
- Significant changes to patient medical regimen
*National billing standards require these issues to be billed separately. For management of problems not related to preventive health screening there will be a separate charge in addition to the preventive care charge.
Insurance Coverage for Preventive Services
Insurance companies vary greatly in coverage for “preventive” and/or “routine” services. In addition, several preventive tests have age requirements or other conditions that need to be met in order for the service to be covered.
Please contact your insurance company if you have specific questions about your coverage or benefits. We cannot guarantee benefits on behalf of your insurance company and advise you to contact your insurance company prior to receiving any services if you have concerns about potential financial responsibility.