Annual Wellness Exams
Are you looking to schedule an annual wellness exam?
Call 907-456-8191 or request an appointment through our patient portal
"Annual wellness exam" means one thing to insurance companies and it can mean another to patients. Here are some tips to help you decide if you should make an appointment for an annual wellness or a problem visit.
What is an annual wellness exam?
An annual wellness exam is a comprehensive preventative exam with your primary care provider, or Ob Gyn provider, for the sole purpose of preventative care. A wellness exam does not include discussion of new problems or management of chronic conditions. These exams may also be called annual exams, routine check-ups, yearly exams, an annual pap, or preventive visit. Mammograms are often ordered at these exams.
Will my insurance pay for a wellness exam?
Most health plans will pay for one wellness/preventative exam per year. Your insurance provider may consider this to be once per calendar year, or require you to wait until a year and a day since your last one. If you have had any other visit billed as preventative during this time period, then your plan is likely to deny your wellness exam. This would include a well-woman exam or pap smear. Your plan may not pay for all testing and/or labs ordered during your wellness exam. If your provider has a concern and orders diagnostic testing and/or labs during your exam, you may be billed separately.
Chena Health participates in the Alaska Breast and Cervical Screening Assistance Program, which covers breast and cervical health screenings for eligible Alaskans. The application is good for one year from signature date. We offer the application form to all patients who are coming in for female wellness exams at time of check-in. The application is optional and there is no penalty for declining. More information about this program can be found on their website.
What is the difference between a wellness exam and a problem visit?
Annual wellness exams are comprehensive, overall reviews of your health with the goal of finding possible issues before they become medical conditions. Preventative and screening tests are performed at these visits that are recommended for your age, sex, and family history.
Problem visits are for evaluating and monitoring current problems or concerns. Follow-up visits that address chronic conditions or medications are also considered a type of problem visit. Establish Care visits are considered a type of problem visit as well, as they address conditions that you currently have.
Can I have a wellness exam and problem visit at the same time?
These can be done on the same day, but this can complicate the billing for the visit and result in a patient balance for the visit. If possible, please schedule a separate appointment, on a different day, if you have any new concerns or other ongoing health problems that need more attention. Should your wellness exam turn into a diagnostic or problem-oriented visit your provider may discuss this with you and bill accordingly.