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Medicare Annual Wellness Visits: Overcoming the Roadblocks to Success

Medicare developed the Annual Wellness Visit (AWV) benefit to provide coverage in order to ensure that beneficiaries receive the most appropriate care by the most appropriate provider at the most appropriate time. This is accomplished by coordinating patient care through one central provider – usually a primary care provider (PCP). The process works by having a yearly review and update of all services/care rendered to the beneficiary.

Some misconceptions regarding the AWV are:

  • It is an annual preventive service.
    • In reality: it is more like case management.
  • It includes a comprehensive examination.
    • In reality: it only requires some basic vital signs.
  • It requires a physician, nurse practitioner or physician assistant to perform.
    • In reality: several licensed medical professionals can perform the service such a nurse or registered dietician.
  • It must be done as a stand-alone service.
    • In reality: other services may be provided during the same visit
  • The forms must be completed while the patient is in the office.
    • In reality: patients may complete the required forms prior to the appointment.

Five common concerns that are preventing providers from performing and billing for this service, are that, just like any new service, you must develop methods for the following:

  • Identifying eligible patients
  • Communication and marketing
  • Visit scheduling
  • Understanding the AWV requirements
  • Conducting the encounters

While starting the process can seem overwhelming, the cost-benefit and patient care benefit make providing the service profitable to a practice. Blue & Co. can assist you with the development of your Annual Wellness Visit program.

If you would like to learn more about the AWV or help in implementing the service in your practice, please contact Angela Babb at ababb@blueandco.com.

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