Benefits Connect

As an extension of Mayo Clinic Human Resources, Benefits Connect brings together benefits experts, plan members, and those who are curious about benefits to share their experiences and knowledge. Each new post is designed to go beyond simple resource information to practical advice on the best strategy to get the most out of the industry-leading benefits at Mayo Clinic. Join the conversation by commenting on posts and replying to comments.

PUBLIC PAGE
Sep 18, 2017

Are you taking advantage of the Preventive Care Services schedule?

By Robert McGriff, @m039153

primary-care

Early detection is very often the key to disease treatment and management.  The Preventive Care Services schedule in the Mayo Medical Plan was designed to encourage everyone to seek appropriate preventive care.  The items on the schedule, at the age and frequency listed, are covered 100% at an in-network provider.  That means they are essentially free to you!

However, here's a quick word of advice:  if you and your provider are too proactive, you can end up paying a price.  Recently, a Mayo Clinic employee in Rochester received a notice from her primary care office that she was approaching a milestone birthday and reminding her that it would be a good time to schedule preventive care including a mammogram.  She called to schedule the exam and was lucky enough to get an appointment within a few weeks.  The problem?  She was still 14 days short of her birthday.  She was surprised to learn that a portion of the bill was applied to her deductible and her coinsurance amounts and she was responsible to pay.  To avoid getting caught in this situation, always make sure that you have passed the required age limit when the exam is performed.

Action Item:  Print our the Preventive Care Services schedule and carry it with you to your next primary care office visit to discuss with your provider.

For us here at the health systems, we would have to go to Rochester for the BRCA risk assessment, counseling and genetic testing. Is Rochester considered a tier 1 or 2 provider?

COMMENT
@daniellek23

For us here at the health systems, we would have to go to Rochester for the BRCA risk assessment, counseling and genetic testing. Is Rochester considered a tier 1 or 2 provider?

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Mayo Clinic providers are Tier 1 in-network providers in the Mayo Medical Plan.

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to take advantage of the BRCA risk assessment, counseling and genetic testing listed in the preventative care services schedule is there a certain way the primary care provider needs to order this?

COMMENT
@dabarrand

to take advantage of the BRCA risk assessment, counseling and genetic testing listed in the preventative care services schedule is there a certain way the primary care provider needs to order this?

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Generally, preventive care needs to be billed with a diagnosis code that is appropriate. You providers office should be familiar with the correct coding.

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