A Vermont primary care practice in Montpelier warned patients to be careful what they ask during a checkup because they could wind up with a bill, according to journalism platform VTDigger.
The warning was from Integrative Family Medicine regarding yearly physician exams.
In a letter sent to patients this fall, the practice warned that "insurance coverage for yearly physical exams does NOT include review or discussion of new or current health problems," according to the report.
Patients were told that if they ask their primary physician about a new or current problem, "your insurer may have us bill you for the services above and beyond the yearly physical exam limit."
Teresa Fama, MD, a rheumatologist at Berlin-based Central Vermont Medical Center, told VTDigger the letter aimed to provide transparency, so patients are not surprised. But the practice stopped sending the letter in October after patients raised questions.
Mike Fisher, the state of Vermont's healthcare advocate, praised the intent of the letter but expressed concern that patients may be less likely to discuss health problems if they think they will receive a bill, according to VTDigger.
Under the ACA, certain preventive services must be provided to patients at no charge. But patients can be charged for services that go beyond the scheduled visit, such as when a provider addresses an acute medical issue during a patient's annual physical.
For example, if a physician finds a polyp and removes it during a patient's routine colonoscopy, the patient may incur additional charges because the polyp removal was therapeutic rather than preventive.
Various healthcare groups and organizations have warned patients about the issue, including Winston-Salem, N.C.-based Novant Health and healthcare providers in South Carolina.
Although the letter from the Vermont practice was discontinued last month, hospital officials hope to revise it and resend it in December, Ms. Fama told VTDigger.
It is not clear what the new letter will say.
More articles on healthcare finance:
10 hospitals seeking RCM talent
Physician practices spend nearly $3B annually updating provider directories, survey finds
Company in federal surprise billing debate to staff 2 Maine hospital ERs