About Billing & Additional Costs
At Metropolitan Pediatrics, we do our best to address your child’s health needs during every visit. With well visits, this can be tricky. Here’s why:
During a well visit, insurance companies want providers to stick to preventive care. Addressing an illness or problem (like an ear infection or rash) or managing a previously diagnosed health problem (like asthma or ADHD) is not considered preventive care. If this happens, you might have extra costs.
“Can you also take a look at…?”
Possibly. Tests and procedures to diagnose or treat health problems are not considered preventive, so you may get a bill for them later. Here are some examples of non-preventive care you could receive during a well visit that may have an additional cost:
- Discussing new symptoms
- Unplanned procedures
- Treatment or testing for new/existing conditions
Occasionally, you may see both a well visit and an office visit billed on the same day. This happens when you meet the requirements of both types of visits in a single visit (e.g., a checkup combined with problem-focused care, such as treating an ear infection or rash).
Questions?
Call (503) 466-1668, 8am to 5pm, Monday through Friday. We also offer options like payment plans and financial assistance for families that qualify.
Routine Well Care
We follow the American Academy of Pediatrics’ Bright Futures recommendations for pediatric preventive care, which include:
- Neonatal State Screen Blood Test = Checks for 40+ rare disorders that can cause brain damage or death if not treated early. Learn more at Oregon Health Authority Newborn Screening.
- Dental varnishing = Topical application of fluoride to help prevent tooth decay
- Developmental Screening = Checks whether your child’s development is typical for his or her age
- Dyslipidemia screen = Checks cholesterol and triglyceride levels
- Hearing screening = Checks for hearing problems
- Hemoglobin = Checks for anemia
- Immunizations
- Lead level = Checks for lead exposure
- Reproductive health = Health education surrounding male/female reproductive systems
- Resilience
- STD/HIV Screen = Checks for HIV and sexually transmitted diseases
- Vision screening = Checks for vision problems
- Sports physicals = Oregon schools require a pre-participation exam and OSAA form before an athlete is cleared to play team sports. An annual well check also meets the requirements of a sports physical and is 100% covered by most insurance plans. We will complete the OSAA form if you’ve had a well check within the last year.
Some health plans do not cover screenings, even though they are the national standard of care. Call your insurance to check your benefits.
