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Patients' Understanding of What Constitutes a Preventive Care Visit

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While efforts to abate surprise medical billing, such as the kind that come from out-of-network emergency department visits, are currently being debated in Washington, DC, the kind of billing discussed here occurs when patients struggle to understand the difference between preventive health services, which are covered at no cost under the Affordable Care Act, and billing for services at a doctor’s visit for an illness, condition, or injury.

On this Managed Care Cast, we speak with a health policy researcher who got the idea for a study about medical billing appearing in the December 2019 issue of The American Journal of Managed Care® after she received one that was unexpected. While efforts to abate surprise medical billing, such as the kind that come from out-of-network emergency department visits, are currently being debated in Washington, DC, the kind of billing discussed here occurs when patients struggle to understand the difference between preventive health services, which are covered at no cost under the Affordable Care Act, and billing for services at a doctor’s visit for an illness, condition, or injury.

Katie Schmitz, a graduate student pursuing a master’s degree in health communication from Purdue University, is one of the coauthors of "Preventive/Office Visit Patient Knowledge and Their Insurance Information Gathering Perceptions."

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