Texas Children's Health Plan
Community Health Choice
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Will I Get a Bill From My Well Check?
Why is there a balance for a Well Check?
What is Included in a Well-Baby/Child Visit (also known as a preventive care visit):
- Age appropriate history
- Age appropriate medical exam
- Anticipatory guidance (such as reducing fall risks for early walkers)
- Preventive counseling (such as proper nutrition)
- Review of vaccine history
- Review and interpretation of any recommended labs or age appropriate screenings
What other preventive related services will or may be billed separately:
- Vaccine products*
- Vaccine administration services (including counseling)*
- Routinely recommended labs+
- Screenings with a separate procedure code (eg, vision, hearing, developmental and brief emotional behavioral screenings)+
- If during your child’s well visit a significant and separate problem must be addressed, an additional non-preventive office visit may be charged. Please note that well-child exams do not take into account this extra work of evaluating and managing either an acute or chronic medical condition.
- If during your child’s well visit it is determined that another procedure must be performed to address a problem, this procedure may be billed out separately. Examples may include (but not limited to) wart removal, circumcision, impacted ear wax removal, foreign body removal, pulmonary function tests, breathing treatments, or labs to address acute or chronic medical conditions. Due to time and insurance contstraints, you may be asked to schedule a separate visit to address these concerns.
- As always, feel free to contact our Billing department if you have further questions. However, keep in mind that our office is limited to specific information regarding your individual coverage or plan.
Vaccines under the no-cost sharing follow the recommendations of the Center for Disease Control Advisory Committee on Immunization Practice or the American Academy of Pediatrics. All other vaccines given for travel or other purposes not routinely recommended most likely will incur a charge.
Services under the no-cost sharing must fall under the AAP’s Recommendations for Preventive Pediatric Care or the United States Preventive Medicine Services Task Force A or B Recommendations.