Same-day E/M services: what to do when a health plan won't pay.

W hen Aetna recently agreed to stop bundling problem-oriented services with preventive services provided on the same date, the AAFP contacted 40 other health plans and asked that they follow Aetna’s lead. To date, none have agreed to change their policies, although a few did respond that they already allow payment for both services on the same date (see “Aetna’s decision” at right for more information). While Aetna’s policy change will make a positive difference for many family physicians, most continue to face the same old dilemma: Should you provide both services at one visit knowing you’ll get paid for just one, or should you ask the patient to return for a second visit knowing the inconvenience this will cause? Most family physicians choose the first approach, but some have reluctantly decided the second approach is necessary. This article describes processes that make it easier to implement.