Finding Payer Policies

September 1, 2008

I have one payer (UnitedHealthcare) who consistently won’t pay for an office visit and pap on the same date of service. Ladies do not want to have to come back on a different day for me to address their hypertension or allergies or whatever. I’ve not seen a written policy on this from United. Any ideas?

Question: I have one payer (UnitedHealthcare) who consistently won’t pay for an office visit and pap on the same date of service. Ladies do not want to have to come back on a different day for me to address their hypertension or allergies or whatever. I’ve not seen a written policy on this from United. Any ideas?

Answer: A quick search of United’s Web site brought up its policy, which is not to pay for a problem-focused visit and Pap done during the same visit. So my first advice is, at the very least, to take advantage of the information payers do make available to you so you are clear what is covered.

Also, I assume that women don’t come in solely for a pap, but also for a preventive care visit that includes the pap. Look into coding for a full preventive exam, assuming you are doing that, instead of just the pap.