Wellness Examinations

What is a wellness exam?

In simple terms this means that our medical providers will perform a baseline medical exam, review your medical history, lifestyle, and other identifiable risk factors which might include age, sex, race, smoking, diet and family history. They will then make suggestions about which preventative testing you would benefit from such as a mammogram, colonoscopy, cardiac testing etc.

 

When should I schedule a wellness exam?

1.     If you know that it is covered 100% by an employer or health insurance plan.

2.     You have no medical problems at all and would like to know what preventative screenings and services you might need (mammogram, colonoscopy, cardiac testing, vaccines etc.)

3.     You have a form from your employer which a physician needs to complete.

4.     Your healthcare plan requires an annual wellness examination in order to qualify for continued benefits.

When should I schedule an annual exam instead of a wellness exam?

1.     You are concerned about symptoms you have been experiencing.

2.     You would like to change medications due to adverse side effects.

3.     You want peace of mind about your health but also have minor concerns (ex: cough, wheezing during exercise, weight gain, etc.)

4.     You’d like to talk about your chronic conditions such as asthma, heart disease, diabetes, etc.

5.     You have abnormal testing results that will likely result in a new diagnosis or treatment plan.

6.     Your insurance plan does not offer wellness benefits.

 

How do you determine whether to bill a wellness or routine examination?

Stonebriar Medical Associates follows the current procedural terminology (CPT guidelines) which is the standard guideline for billing all health insurance carriers. In 2018 the CPT codes for wellness exams range from 99381-99397.