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Questions Can Trigger 'Split Visit' Charge At Doc's Office

MINNETONKA, Minn. (WCCO) -- Susan Krantz has a medical and business background; but when she got her latest medical bill from a recent visit, the Minnetonka woman was perplexed.

"Even as a registered nurse, I can't figure out what this is," she said.

Krantz was upset when she opened a recent bill. Along with the list of procedures was the itemized charge of $50.06 for something she couldn't make out. When she questioned Park Nicollet, the response puzzled her.

"You can be charged an extra office visit if you ask too many questions," she said. "I said I don't understand that, because isn't that what this visit is for?"

Medical services are carefully coded for insurance purposes. As Park Nicollet explained to us, the billing has to accurately reflect the medical services provided. If the doctors feel their work goes beyond the scope of the visit, they must code that on the bill. That's to assure that coverage for a "wellness" visit doesn't fraudulently cover care given to an "acute care" matter.

In Krantz's case, the question that triggered her extra charge was for a concern she raised about a sore hip.

She added: "As always the doctor's visit started out with her asking what questions do you have? And I had a little list. This one and this one and this one. And she said, OK."

Park Nicollet says it's an insurance issue. In a written statement, the medical provider said that "the insurance company may require that patients pay or make a co-pay for services beyond the 'preventive' part of the appointment."

The statement goes on to say that the total amount billed to the insurance provider is the same as if it were one appointment, only it's "broken out separately on the invoice."

Krantz is now spreading the word among her friends.

"I'd have never known had I not taken the time to call," she said.

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