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Old 03-22-2013, 08:39 PM   #41
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Thanks, I am working on all of that.
Great! Sounds like you are all set.

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As a retired federal employee I have excellent insurance.
Bring your insurance card with you to the appointment, if you have it. They'll probably want to the information off of it, so that they can file the claim for you.
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Old 03-22-2013, 08:42 PM   #42
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Make sure to request a prostate exam.
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Old 03-22-2013, 08:52 PM   #43
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Make sure to request a prostate exam.
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Old 03-23-2013, 08:01 AM   #44
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What you are suggesting is not standard of care.
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Heh, no, not replace a $12 test,hehe. Just give some ammo if the test comes back in the realm of maybe I can put this person on a drug for the rest of her life.
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Old 03-23-2013, 09:56 AM   #45
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Not to hijack, but an observation.

I've had a physical every year for the last 30 years. In the past, the doc would have you strip down to nothing but a gown, and check your whole body for moles, check your feet, look into every orifice including a prostate check, thunk your abdomen, check for hernias (cough!).

During this last exam, I was fully clothed, spent most of the time answering questions and practically had to beg for a cholesterol test. (Was good last year, no need to repeat yearly). I don't know if this was policy change or the fact the the doc I got was a recent grad., but I'm starting to wonder what an good physical should entail.

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Old 03-23-2013, 10:52 AM   #46
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Don't fear modern medicine. It is a great tool and we benefit mightily from it. But, also, do not fear questioning modern medicine. Doctors today are rushed and pressured from all sides. As human beings they will make mistakes at times, and at other times take the easier way out. You must manage your own care to the best of your ability. A doctor is a professional you hire to do to a job. Nothing more.
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Old 03-23-2013, 01:25 PM   #47
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Back in the day when I was retired but before I was on Medicare, my doc bemoaned the fact that my insurance, United Healthcare, did not tell the doctor what tests and exams could be performed on a routine annual physical that would be 100% covered by insurance. What doc wanted was a list from UHC for the exams/tests that could be performed and would be reimbursed 100% as part of a routine annual physical, that is, with no diagnosis or symptom stated.

Disclaimer: My UHC insurance was provided through my Megacorp, which is self-insured. UHC handled the paperwork and Megacorp made the rules and paid the bills. It's different now that I'm on Medicare. UHC/Megacorp lets Medicare decide what to pay.
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Old 03-23-2013, 02:22 PM   #48
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Originally Posted by travelover
Not to hijack, but an observation.

I've had a physical every year for the last 30 years. In the past, the doc would have you strip down to nothing but a gown, and check your whole body for moles, check your feet, look into every orifice including a prostate check, thunk your abdomen, check for hernias (cough!).

During this last exam, I was fully clothed, spent most of the time answering questions and practically had to beg for a cholesterol test. (Was good last year, no need to repeat yearly). I don't know if this was policy change or the fact the the doc I got was a recent grad., but I'm starting to wonder what an good physical should entail.

Back to Khan.
That has been my recent experiences, and that is why I haven't gone in over 3 years. I now just get my BP and cholesterol checked on my own for free at health fairs when they pop up. When I turn 50 I may go and see if a doctor can convince me to get my prostate and/or colon checked.
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Old 03-23-2013, 02:55 PM   #49
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Be careful. If you mention an "ailment" during your first visit the visit probably will not be coded as a 100% covered "wellness" visit. The office visit and the tests now become related to whatever ailment you complained about. If you want this visit to be covered 100% under "wellness benefit," my suggestion is to save any complaints for the second visit. During the second visit, the doc will have all the results ordered during your covered "wellness" visit and can order any additional as required to address your specific complaint.

If this is your first visit to this doctor, the doc's office may code the visit as a "new patient exam" which may not be covered 100%. Maybe your insurance is good enough that you won't end up paying much even if the visit is not coded as a "wellness" visit but I don't want you to be surprised when you discover that the office call and the tests are not covered 100% under your "wellness" benefit.

My doctor moved away and I wanted to go in for a covered "wellness" exam with another doctor. I called and talked to the billing weenies at the doctor's office and they said they would not code the first visit as a "wellness" visit that is 100% covered even though I have no complaints and I am coming to see the doctor for a "wellness" check. Looks like I'll have to first pay about $100 for a "new patient visit" ("Hi, I'm a new patient. Can I go now?" and then return for a 100% covered "wellness" visit that includes blood tests. I have a high deductible policy so I pay the first $6,000 in charges.

My annual "wellness" check and associated tests are covered 100% without meeting my deductible but I am at the mercy of the doc's office and how they code the visit. I have to be sure how the visit will be coded before I step in the door or I could be surprised by the bill.

Asking for pain meds on the first visit might caused a raised eyebrow. I'm not sure I'd go there.
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Old 03-23-2013, 02:57 PM   #50
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Just go, get it done, and keep healthy. There. :-) I have been both on the provider side and on the receiving end also, no need to make a big deal out of this.
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When I turn 50 I may go and see if a doctor can convince me to get my prostate and/or colon checked.
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Old 03-23-2013, 03:11 PM   #51
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Just go, get it done, and keep healthy. There. :-) I have been both on the provider side and on the receiving end also, no need to make a big deal out of this.
I am only 48, Obgyn, so I can put it out of my mind for a little while longer. I must admit though, the thought bothers me as only my GF's have been anywhere close to those areas. . Buckeye, that is one advantage I have over you on my high deductible plan. It has no provision for any insurance payment before the $5500 deductible. So I know someone is digging into my wallet no matter what happens.
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Old 03-23-2013, 03:20 PM   #52
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I am only 48, Obgyn, so I can put it out of my mind for a little while longer. I must admit though, the thought bothers me as only my GF's have been anywhere close to those areas. . Buckeye, that is one advantage I have over you on my high deductible plan. It has no provision for any insurance payment before the $5500 deductible. So I know someone is digging into my wallet no matter what happens.
I thought, by law, insurance policies have to cover one "wellness" visit per year?
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Old 03-23-2013, 03:43 PM   #53
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I thought, by law, insurance policies have to cover one "wellness" visit per year?
Not on the grandfathered plans, at least mine this year anyways. I checked online and it hadn't changed yet. I get to pay $5500, then they are supposed to pay for everything above that.
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Old 03-23-2013, 03:53 PM   #54
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Not on the grandfathered plans, at least mine this year anyways. I checked online and it hadn't changed yet. I get to pay $5500, then they are supposed to pay for everything above that.
We purchased our plan in April 2011 and, like you, are covered 100% for the remainder of the year after meeting our deductible. Humana One. IIRC, the covered wellness visit was added after we purchased the policy.
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Old 03-23-2013, 06:09 PM   #55
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Don't fear modern medicine. It is a great tool and we benefit mightily from it. But, also, do not fear questioning modern medicine. Doctors today are rushed and pressured from all sides. As human beings they will make mistakes at times, and at other times take the easier way out. You must manage your own care to the best of your ability. A doctor is a professional you hire to do to a job. Nothing more.
I agree 100%! And has a hired gun, you probably want to pick one out very carefully. Someone right out of medical school might lack experience, but might not hold a lot of bias on science that was later disproven. But they might lack experience. Or you could go with more experience. I'm no doctor picking expert, but I guess there's an internist and GP, and various other designations. That might be the difference in what a "routine physical" entails?

--Dale--
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Old 03-23-2013, 06:20 PM   #56
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What you are suggesting is not standard of care.
I don't know what that even means. I do know that some doctors prescribe statins without making any attempt at lifestyle changes, which was what I was warning Kahn about. I also know that CIMT allows the doctor to visualize effects of a disease process, whereas a lipid profile requires ascribing truth to a theory, or set of theories, and basing action on the outcome of that process. Another thing I know is that there is no concensus between doctors, and in fact there is quite a wide divergence between doctors on what actions are appropriate after having seen only standard lipid profile test results. This is based on personal experience and discussions with a handfull of my work associates, comparing notes. So are there any tests you DO suggest for Kahn that would give a better indication if CHD was present, or is the blood test good enough for a scrip in your book?
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Old 03-23-2013, 06:40 PM   #57
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When you're scheduled for blood tests (lab work), you should certainly fast at least from midnight before your blood draw. Some tests will give inaccurate readings otherwise. Also, at your age you should also consider the pneumonia vaccine in addition to the shingles one.

I would say the most important thing to keep in mind is twofold:

A. Make a list of questions and take it with you to the appointment so you can remember to ask them all.

B. Bring a notepad so you can jot down the answers you get.
One thing that seems at bit strange, the cost of a blood glucose monitor and 50 test strips is far less than the cost of a lab based test. Why not use this and do say readings for 20 days, before hand. Likewise, one should IMHO get a home blood pressure cuff and go to the physican with a 20 day record of bloodpressure, to avoid the white coat effect (i.e. being around someone in a white coat causes the blood pressure to rise).
In my case having high blood pressure which is treated I provide such a list to my physician at every visit and there is talk of integrating this with the smart phone, so that to monitor blood pressure no visit to the office is needed.
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Old 03-23-2013, 06:47 PM   #58
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I would prefer not to discuss medical topics on this website, as this is not why I joined. However, I cannot let anyone telling a forum participant, without knowing her medical history, and who has not seen a provider in 20 years, that "what you want is a carotid IMT test" for her first visit, instead of following basic ATP treatment guidelines for example. This has nothing to do with being for or against the use of statins with or w/o CHD. This will be my last post under this thread.

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I don't know what that even means. I do know that some doctors prescribe statins without making any attempt at lifestyle changes, which was what I was warning Kahn about. I also know that CIMT allows the doctor to visualize effects of a disease process, whereas a lipid profile requires ascribing truth to a theory, or set of theories, and basing action on the outcome of that process. Another thing I know is that there is no concensus between doctors, and in fact there is quite a wide divergence between doctors on what actions are appropriate after having seen only standard lipid profile test results. This is based on personal experience and discussions with a handfull of my work associates, comparing notes. So are there any tests you DO suggest for Kahn that would give a better indication if CHD was present, or is the blood test good enough for a scrip in your book?
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Old 03-23-2013, 07:44 PM   #59
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It has been many years since the OP has seen a physician - - I would add to the ask list recommended vaccinations and where to obtain them.

Also ask for a GYN recommendations.

You will probably need a colonoscopy, as for recommendations for a GI.

Keep in mind that once you are over 65 Medicare is primary and your health care providers must deal with their rules.
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Old 03-23-2013, 07:55 PM   #60
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I agree 100%! And has a hired gun, you probably want to pick one out very carefully. Someone right out of medical school might lack experience, but might not hold a lot of bias on science that was later disproven. But they might lack experience. Or you could go with more experience. I'm no doctor picking expert, but I guess there's an internist and GP, and various other designations. That might be the difference in what a "routine physical" entails?

--Dale--
You reminded me of a quote Coach Bobby Knight said quite a few years ago. Paraphrasing it went something like this... Why the hell does everyone want to know my won/loss record, and no one seems to care what a doctors is.
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