Friday, May 16, 2014

Forbes: Medicare's Wellness Program Is Quite Unwell

By Coleen Elkins

Medicare touts their "free" wellness program but it appears to have some broken hinges. If during the course of a wellness exam a diagnosis is discovered the exam is no longer "free". The code used and sent to Medicare now makes it a billable event.

The Forbes article uses a colonoscopy as an example. If you have a "free" colonoscopy as part of your wellness exam and a polyp is found that changes the procedure to a diagnosis code and charges would apply. This can be very costly and comes as a huge surprise when the patient receives a balance owing bill in the mail.

In February of 2013 there was an article indicating that the administration was working to change this but appears that the changes may have not been implemented. This is the article from 2013
Obama Administration Tackles Colonoscopy Confusion

This is the Forbes Article indicating this is an ongoing issue yet today. Forbes Article