Well visits

A Combined Care visit happens when your child’s clinician addresses and completes more than one type of care during the same appointment. This may include completing a well-child visit during a sick visit, if your child is due, or addressing additional medical concerns during a scheduled well-child visit. Combined Care visits allow families to take care of everything in one visit rather than scheduling a return appointment.

Well-child visits are considered preventive care and are typically covered by insurance at no cost to you. However, when additional concerns or conditions are evaluated and managed during the same visit, insurance plans may apply additional copays, deductibles, or coinsurance based on the patient’s specific benefits. This billing reflects the additional time, medical decision-making, and complexity involved in addressing concerns beyond the preventive exam.

Preventive services typically covered as part of a well-child visit include: a conversation about your child’s medical history (including social and family history), height and weight screening, age-appropriate immunizations (based on your plan’s coverage), developmental and behavioral screenings, routine physical examination, and preventive health counseling such as nutrition and safety guidance.

Additional billing may apply when your child’s clinician evaluates or manages concerns beyond the preventive exam, such as new symptoms (fever, cough, rash, ear pain), chronic or ongoing conditions (asthma, allergies, ADHD), medication concerns or prescription refills, behavioral or mental health evaluations, and certain specialized screenings (autism evaluations, adolescent depression screenings, and similar) that fall outside your plan’s preventive coverage.

Most insurance plans cover the preventive portion of a well-child visit at no cost. However, coverage for additional services to address conditions or concerns varies by plan. We recommend contacting your insurance provider directly to understand your specific benefits, including any copays, deductibles, or coinsurance that may apply to non-preventive services.

Absolutely. If you prefer to keep your visit focused on only what your child was initially scheduled for, you can let your child’s clinician know. Any additional care can be scheduled as a separate return appointment. However, many families find it more convenient to address everything in one visit rather than making an additional trip to the office. Your clinician will always prioritize your child’s health and safety, so if a concern requires immediate attention, they will discuss this with you.

If you have questions about charges from your child’s visit, please contact our billing department by calling 949-599-2434. Our team can help explain the services billed, assist with insurance questions, and work with you on any concerns. You can also contact your insurance provider directly for details on your specific plan’s coverage. 

Sometimes additional services that were already documented and provided during your child’s visit are identified through a post-visit review and billed accordingly.

As documentation is finalized and reviewed, claims may be updated to ensure services provided during the visit are accurately reflected and submitted to the patient’s insurance plan. If you have questions about a specific charge, please contact our billing team by calling 949-599-2434.