Office Visit Fees Explained: What Every Patient Needs to Know

Have you ever gone to a follow-up appointment or a quick procedure and wondered why you were charged an office visit fee on top of everything else?

In this episode of Take Care, Melody Mulaik answers a listener's question about when it's appropriate for healthcare providers to bill an office visit separately from a procedure. She explains how surgical global periods work, when follow-up visits should already be included, and why some procedures may not require an additional evaluation and management (E/M) visit.

Understanding these billing rules can help you spot potential billing errors, ask the right questions, and avoid paying for services you shouldn't be charged for.

What You'll Learn In This Episode:

• What an office visit (Evaluation & Management) charge actually covers
• Why some post-surgical follow-up visits should already be included
• The difference between 0-day, 10-day, and 90-day global surgical periods
• When an office visit can legitimately be billed with a procedure
• Why does removing a mole not automatically justify an office visit charge
• How does bringing up a new medical concern change billing
• When physical therapy is billed separately
• What to do if you think you've been billed incorrectly
• How your insurance company can help review questionable charges
• Tips for advocating for accurate medical billing

Timestamps:

00:00 Listener question: Why am I being charged an office visit every time?

01:00 Understanding post-surgical follow-up billing

01:45 What are global surgical periods?

02:30 The difference between 0-day, 10-day, and 90-day global periods

03:15 When follow-up visits should be included

03:55 Why physical therapy is billed separately

04:15 Billing rules for mole removal and minor procedures

05:00 When a new medical concern creates a separate office visit

06:00 How providers determine whether an office visit is billable

06:45 What to do if you believe you've been billed incorrectly

07:30 Final advice on advocating for accurate medical billing

Have a healthcare billing or insurance question you'd like answered on the podcast? Visit our website and submit your question for a future episode.