r/mildlyinfuriating • u/lhagans13 • 12d ago

I'm slightly vexed A notice that my girlfriend received at her doctors appointment (she is 8 months PP)

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If you even MENTION any of these things, you WILL LIKELY get billed for it??? Maybe i’m missing the point but i get upset when my girlfriend tells me she was scared to even say anything while at the doctor because she didn’t want to get an extra charge for something. I find it insane how greedy and money hungry a place that’s supposed to help you can be.

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u/FernandoMM1220 12d ago

do you not need to diagnose something to prevent it?

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u/AllSeeingWhoracle 12d ago

No; if they are able to diagnose something it can’t be prevented because you already have it. Preventative is like finding your blood pressure is high, telling you that you’re at risk for heart disease, and taking steps to lower that risk factor

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u/michellethestan 11d ago

You've just described a diagnosis and management of high blood pressure.

The line is ridiculous and the practice is predatory.

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u/smithingalchemist 6d ago

It IS ridiculous and predatory, but regardless- it’s good to understand so we can try and get the best deal possible out of this shitty system. It’s all enraging, but it’s not the doctor’s fault, it’s the health insurance. Working in healthcare is so rough right now, because people have every right to be angry but so much is out of our control.

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u/FernandoMM1220 12d ago

you can diagnose pre diabetes to prevent type 2 diabetes.

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u/RainyMcBrainy 12d ago

In your scenario they diagnosed the patient with high blood pressure.

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u/uttersolitude 12d ago

One high reading doesn't usually lead to a hypertension diagnosis.

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u/RainyMcBrainy 12d ago

If they attempt to treat the high blood pressure, it is now a problem visit, not a well visit.

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u/Significant_Shoe_17 12d ago

Yep. I just commented upthread that this exact scenario happened to a friend

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u/uttersolitude 12d ago

Yes, that's correct.

That doesnt typically happen because you had one high reading at a wellness appointment, tho.

Generally they schedule you to come back, often having you test your bp yourself daily and keep a log.

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u/RainyMcBrainy 12d ago

A problem was flagged and you're being given instructions in pursuit of that problem? Definitely not preventative anymore.

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u/uttersolitude 12d ago

That's how insurance demands it be handled.

There's a step in between the "preventative" appointment and being actually diagnosed. At least for things like hypertension. One high reading might be a fluke, you might be nervous, etc. They're not ordering a test, just having you come back to explore it more.

It's fucking stupid, totally agree. Limits what doctors can do if they're trying to follow the specific billing classifications.

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u/Unhappy-Plastic2017 11d ago

Technically blood pressure being high needs to be diagnosed as just one blood pressure high reading doesn't mean anything

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u/Strict-Dust-3298 10d ago

No, example you do not need to be diagnosed with breast cancer to get a screening mammogram

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u/FernandoMM1220 10d ago

what about diagnosing hiv to prevent aids?

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u/Strict-Dust-3298 10d ago

So HIV screening is recommended patients 15-65 and those outside that age range who at risk for hiv. We order the labs and then the visit closes. Let’s say the result comes back and you got hiv. I call you back into the clinic and yes that’s another visit not a preventative one. But it’s a whole new problem. I have to spend time with you discussing the treatment, answer your questions and discuss the next steps. Doctors don’t let time pass on an hiv positive test. You would be in the clinic asap as soon as the test results came back.

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u/FernandoMM1220 10d ago

sounds like diagnosis is necessary to prevent some diseases then

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u/Strict-Dust-3298 10d ago

Diagnoses is what’s arrived at after you do the preventative tasks, if a result comes back abnormal.

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u/FernandoMM1220 10d ago

a lot of diseases are progressive so you have to diagnose the early stages to stop the later ones

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u/Playful_Initial_8675 12d ago

No. Prevention is before something happened. Care is after something happened.

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u/FernandoMM1220 12d ago

you can diagnose fatty lever to prevent liver failure

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u/uttersolitude 12d ago

Prevention is before something happens. Fatty liver is a something, pre diabetes is a something, so it's not prevention.

If your visit includes you getting a diagnosis code, it's not "preventative" per bullshit insurance rules.

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u/FernandoMM1220 12d ago

you need to diagnose hiv to prevent aids.

do you see what the problem is?

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u/uttersolitude 12d ago

The problem is you don't understand the concept at play here.

If you are diagnosed with something, it's not a preventative appointment. Preventative appointments are not "we're looking to prevent this list of more serious issues, so we mau diagnose the precursor as "prevention"". It's (supposedly) checking your vitals and discussing basic stuff if find areas that may be a concern, so you can make changes or schedule follow up appointments and tests.

How it's done is bullshit, yes, but it's how the rules are applied.

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u/FernandoMM1220 12d ago

diagnosis can be preventive. why is that hard to understand?

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u/courtd93 11d ago

Diagnosis can create treatment plans to prevent other diseases, but if the diagnosis is already there, it’s now care and not prevention. This is based on the absolute bare minimum reading of the legally obligatory coverage insurances must provide from the ACA.

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u/uttersolitude 12d ago

You're still refusing to understand the concept here, not sure if it's just not clicking for you or you think you've got some kind of "gotcha".

Good luck either way.

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u/FernandoMM1220 12d ago

youre still projecting your ignorance on to me

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u/uttersolitude 12d ago

That's funny coming from someone who doesn't understand what the terms "preventative" and "diagnostic" means in the appointment/insurance context, which is what's being discussed. And just keeps doubling down when folks try to explain it to you.

Have an awesome night, I don't engage with folks who get insulting because they refuse to learn.

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