Annual Wellness SolutionSimplifying Medicare Annual Wellness Visits
Annual Wellness Visits (AWV) Adoption
31,499,467Medicare patients
4% receive AWVs
1,295,373
Source: Andy Zeigert, The Bulletin
Opportunities and Challenges with AWVs
• Establishing and maintaining a personalized prevention plan
• Billable opportunity ~$150
• Standard framework to follow
• Can be billed with E/M service on same date with -25 modifier
• A lot of administrative documentation
• Time consuming for physicians
• Disrupts practice workflow
• Excludes general exam
• Confusing requirements can result in denials
Example Existing AWV Process
Practice Scheduler
Patient arrives early to complete Health Risk Assessment (HRA) Questionnaire
Schedule visit
Ask patient to bring key information
Review HRAVitals takenComplete screening schedule
Review HRAReview screening scheduleComplete Risks, Results and Follow-up Complete Personalized Health PlanConsult patient
15 mins 20 mins 20+ mins
HRA Paper Form Completed
HRA Paper Form Reviewed
Screening Schedule Form Completed
Results and Risks Form Completed
Health Plan Form Completed
HRA Paper Form Reviewed
Screening Schedule Form Completed
Patient Clinical Staff Physician
Document and Bill
The Essia Well Check Solution
Patient e-Questionnaire Review summary reportsReview and complete vitalsComplete Screeners
Review summary reportsConfirm ordersConsult patient
15 mins 10 mins. (10 min saving)
10 mins. (10+ min saving)
Patient Clinical Staff Physician
Automated Solution Outputs
5-Year Personalized Health Plan
Patient Action PlanAWV Results and Follow-up
Software Features
• Desktop, tablet and mobile compatible
• Single cloud-based tool for the patient and entire care team
• Customized reports for printout and email
• Fully HIPAA compliant
• EMR information prepopulated
• Customizable user access rights and privileges
• Interface designed for simplicity
• Responsive patient questioning
• Intelligent information summaries
Simple, Flexible and Compliant
EMR Information Pre-Population
47 fields exported from EMR.CSV uploadIntelligent data readingTechnical support is provided
Doctors and Support Services.CSV uploadTechnical support is provided
Batch Patient Upload Medical Support Upload
How It Works
Patient information from EMR is reviewed, and scheduler notified of key patient information gaps.
Patients self download health & life circumstances through e-questionnaire, while in waiting room.
Staff reviews e-questionnaire, inputs necessary vitals, and downloads results for physician review.
System codifies the visit and produces a care packet with patient road map & 5-year care plan.
Physician sets orders and consultspatient about care plan.
System shares visit summary andprovides documents for billing purposes.
1 2 3
456
Scribe Augmented Well|Check Solution
Manages all EMR data uploads into Well|Checksoftware
Highlights all information gaps to practice scheduler prior to patient visit
Preps software for patient use and initiates patient e-Questionnaire
Preps software for clinician and physician use
Prints all required software downloads for patient consultation
Completes all required EMR documentation
Checks eligibility from EMR data and C-SNAP
Appendix
AWV FAQs
Who is eligible for an AWV?Medicare beneficiaries 66 or older, not within the 1st
year of Medicare Eligibility, Part B / Medicare Advantage, who haven't had an IPPE / Initial / Subsequent AWV in the past 12 months
Who can perform AWV?Physicians (MD / DO) Non-physician practitioners (PA, NP, CNS) Medical Professionals (Health educator, dietitian, nutritional professional / other licensed practitioner or a team working under the supervision of a physician.)
Billing codes:CPT: G0438 (1st visit), G0439 (all subsequent visits).Medicare will pay a physician for an AWV service and a medically necessary service, as long as the medically necessary service is billed with modifier.
Reimbursement RatesNational Averages are: G0438: $161 | G0439: $137To find the exact reimbursement for your region, refer to the Physician Fee Schedule on cms.gov
AWV Results Goes to the Biller
Lists the health areas in which the patient is at risk. This information is generated based on patient self-responses in the HRA and the assessment from the Provider Encounter.
Findings
Services Referred
Lists the support services and referrals recommended by the provider
5-year Health Plan Goes to the Biller
Lists additional screeners recommended by the patient based on the information provided in the Provider Encounter.
This includes the Medicare Preventive Services, as well as any additional services deemed appropriate by the provider.
Personalized Health Plans
Personalized Action Plan Goes to the Patient
Once the Clinician Report has been generated, the clinician and patient will be able to create a Personalized Action Plan
Based on 3 questions directed to identify:
• Patient health goals
• Actionable steps to achieve these goals
• Confidence in their ability to reach identified goals
Upon completion of the AWV, the care team has the capability of completing the questions above with the patient in the office.
Action Plan