I would like some opinions/advice. Our office has yet to bill both preventive with a problem visit the same day when documentation supports a sepaate E/M in addition to the preventive exam. Mainly, due to the fact that we have some patients who try to squeeze in a physical during their acute/chronic issue appt because their insurance did not provider preventive coverage, and so our physicians would provide both and bill out only one-and vice-versa...provide well child components while addressing my childs allergies-two for theprice of one. Needless to say, this creates seemlessly endless patient calls and complaints, I was there for my problem but you billed out a preventive and the most common complaint recently, my insurance covers an annual exam but you billed this as a problem visit. We must find a way to streamline this process, we can't continue to "guess" on what the patient wants billed. The appt frequently states follow up Diabetes/lipids/HTN and yearly physical exam--and the provider throroughly addresses the problems, ordering labs, refilling meds etc. To top it off, the CC will state follow up on chronic/acute issue and preventive exam. So, in reality both services are provided. The simplest answer in my opinion is to bill for exactly the service/services documented in the note-and in these cases that we bill both preventive and the E/M. I believe I will face some resistance to this, my physicians feel it is their choice to bill as they choose. However, that places us in a precarious position with the insurance company. How does your office handle this situation? Have things changed for you with the new Healthcare Reform? Our current suggestion to patients who ask us to change their problem to preventive (when documentation does not support preventive), is for future visit they should schedule a preventive exam only and schedule their chronic/acute issues at another time (their 3-6 month follow ups), to ensure that a preventive is documented and billed.