I schedule check-ups every two years after the six year physical, but have some families who continue to ask for yearly visits. I've never refused, thinking, O.K., if that's how they want to spend their time and money. But now that my HMO population is slowly getting larger, what do I do if a capitated family insists on yearly visits which are not medically necessary or required by the school? One particular family prompted this post. They're obnoxious, demanding, and impossible to get out of the office once they arrive (the relatives who referred them apologized in advance at the time). Now this family will be moving to N.Y. in two weeks (hooray) and called for a check-up "just to make sure everything's all right before they move." (can I code it 99393-99?). So do I: 1) cave in, or do I 2) have my staff gently explain that their insurance only covers visits every two years at his age (which is my standard) and I know a nice pediatrician in Long Island who would be happy to assume his care after they move! Michael Sachs, M.D. General Pediatrician P.S. Gary, I have no idea which part of New York they're moving to and wouldn't even consider giving your name (or anyone else's) to a family like this.