Billing Preventative Exams along with an OV

I am hoping to get some advice/opinions on how to handle disgruntled patients who call upset when they get charged a copay because they came in for their 100% covered preventative exam but had other acute/chronic conditions they wanted to talk about therefore OV was charged.
I have explained that anything outside the realm of a preventative exam is subject to an ov charge.. they argue that that is what there yearly exam is for is to catch up on everything. In the good ol days there was just one charge.
Any help?

re: Billing Preventative Exams along with an OV

Just an idea....when you check in a patient for an annual how about develping an ABN which they sign. The ABN should clearly specify what and annual exam consists of and advise the addressing, discussion, treatment etc of anything outside of the annual will be billed and any applicable co-pay will be expected to be paid. I imgaine the biggest issue is the patient not being told in advance. We can't assume they just know and hearing it on the back end leads to them being disgruntled. It is good to let them know this as well at the time of scheduling as well if possible this way, you educate your patients and secure payment for rendered services. Best wishes!!!