Talk of The Villages Florida - View Single Post - HMO wants my check up to be every 3 months
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Old 08-23-2012, 09:43 PM
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blueash blueash is offline
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Default Doesn't make sense

Contrary to some postings, I believe that the doctor is paid for the visit, not the HMO. It is the HMO which has to pay the doctor. I would like to see more information from the OP, specifically the name of the HMO. Is this a Medicare advantage plan or a private insurance carrier? I am not aware of any national organization that has recommended 4 times a year routine check-ups. Perhaps the OP could call the insurance company and ask if this call really came from them. Four times a year "annual" exams would overwhelm the already overworked primary care doctors. Only explanation I can come up with is that somehow the HMO has you coded as having an illness that should require more frequent visits like diabetes. It is possible the doctor's office entered a wrong diagnostic code on a charge they submitted to the insurance carrier which triggered this call.