We encourage you to check directly with your insurance plan to get specific answers to questions about your coverage and benefits. Many plans have web sites and customer service numbers. You can also consult your benefit plan book or contact your Human Resources department.
Questions
What is preventive care?
Services provided to evaluate and maintain your health
Medical care focused on preventing future illnesses
Screening tests to detect medical conditions before you have symptoms for certain diseases, such as colon and cervical cancer
One example of a preventive visit is an annual physical, sometimes called a well-check.
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What is a problem-related service?
Services provided to evaluate a specific problem and/or illness
Medical care focused on the history of a problem, assessing the problem and treating it.
Diagnostic tests to help your physician find the problem or the cause of a problem, make a diagnosis and develop a treatment plan.
A visit to a Healthcare Provider for a specific illness or injury, such as a sore throat or bad back, is an example of a problem-related service.
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What is a problem-related service co-payments?
Billing and coverage of Combined preventive problem visits
If a River Falls, Spring Valley or Ellsworth Medical Clinic Health Care Provider provides preventive care and evaluates or treats a problem on the same day, two separate services may be billed - a preventive service and a problem service. This billing reflects the actual services provided. Your portion of the bill will depend on your insurance coverage.
If you have questions about which services are covered, please contact your insurance company. If you have questions about your RFMC bill, please contact our insurance department 715-425-6701 or 800-514-9204.
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What is the 2009 Wisconsin Act 146?
The 2009 Wisconsin Act 146 seeks to make health care costs and charges clearer to consumers. It requires health care providers to disclose, upon request, certain charge and payment information for health care services, tests, and procedures.
Act 146 also requires health care providers to offer information on charges, payments, and possibly on their comparative quality. The Wisconsin Department of Health Services determined that this requirement will be phased in, beginning in 2011 with physicians.
The physicians' report is based on the 25 most common medical conditions (without complications) treated by physicians in Wisconsin among those under age 65. For each medical condition, the five "Related Medical Services" are listed that account for most charges by physicians. (Again, assuming there are no complications.)
Act 146 Document
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