Bundling handout

[Guest guest]

Dr. Carstensen said I could cross post this to another primary care group.

I thought it was a pretty good summary and patient handout of why we sometimes make patients return to the office for further treatment.

Locke, MD

Bundling

Family Physicians want to be ‘good guys’. It’s our nature. We don’t like to say “No” for any reason to any patient. We believe that we should always ‘roll up our sleeves’ and do our best to help you with whatever needs you have.

Today I have to say “You must make a return visit for this.” I want to explain.

In 1966, insurers and physicians designed a system called “Current Procedural Terminology (CPT)” (ISBN: 1-57947-579-5). It is updated yearly. This system divides medical services in to groups. Our office work together usually falls within: Medical (usual illness visits), Preventive (physical exams, or Surgical (warts, cuts, and such).

If you are here for a physical and we agree it is convenient, good medical care to take care of a cold, wart, or adjust blood pressure medicine, insurers ignore the CPT guidelines and refuse to pay for the second service. This is called ‘bundling’.

This seems similar to you or I going to the grocery to buy milk and once there decide to add fruit and bread (different sections in the store). We place them in the bag but only pay for the milk.

Insurers throughout America do this. I’ve had patients ask about this and they are told, “Sure, your doctor can do those things all in one visit”. What they don’t say it, “But we won’t pay them.”

I regret asking you to make a return appointment. It is against my nature. But insurance companies have you and me in a tough spot. My professional organization, the Academy of Family Physicians has been trying for years to change this practice.

If you wish to protest this insurance company practice, I suggest that you contact:

a) Your insurance agent if you have individual insurance.

The Director of Human Services if you are insured through your employer.

c) The Colorado Division of Insurance; 1560 Broadway, #850; Denver, CO 80202

I regret the inconvenience I know this causes you as my patient.

Earl J. Carstensen, MD

Diplomate, American Board of Family Medicine

Fellow, American Academy of Family Physicians