Maybe my insurance is different but it has not interevened in my decision to schedule with a PM or MD. Anyway, if you want to be seen by a Dr, here is an urgent care clinic that has MDs on staff:
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Actually I can give an example of insurance v. health care system v. us.
Years ago when I had my employer's insurance who is Aetna, a "wellness" visit was free, once per year. It's along the theme of this post. This in theory actually might be a win win for the insurance co and the patient. A piece of paper would have the doctor check off, that BP, glucose, and cholesterol were looked at. ONLY THAT THEY WERE CHECKED, and it could be scanned and emailed back by the employee to HR. Not sure how many forgeries this created. As once my employer acknowledged, we'd save $40 per pay.
Once the task went to Meritain (owned by Aetna?), it wanted the actual values, and certification to come from the doctor's office, not the employee.
At any rate, the fine print would be a note to the physician--the wellness visit shall be no cost out of pocket to the patient.
I'd be flabbergasted every time. My doctor's office would collect $0 from me, but then I'd get a bill for the copay, which was $20, and went up to $30. By the way my doctor's office is one of the large health plans in Philadelphia, not a private practice.
Here's the explanation and my boss got the same one in NJ, same health plan.
Wellness checkups shall be done by nurses only, not physicians. If a patient chooses to have a wellness checkup done by a physician, then it will be deemed a regular visit. BOOM!
So no, insurance doesn't say ultimately what to do, but they do in fact along with the provider, determine patient responsibility. It's crazy imho.
Again, not disagreeing with you. For what reason, would any of us, want someone to treat us, who didn't go to medical school? I really believe insurance is telling us, do your part and lower costs for everyone. Really. How about teladocs etc?