Prevounce Blog

An Ounce of Prevention

5 Steps for Preparing Medicare Patients for the Annual Wellness Visit

Read More
medicare patients

5 Steps for Preparing Medicare Patients for the Annual Wellness Visit

by Lucy Lamboley

Taking the time to prepare your Medicare patients for their annual wellness visit (AWV) can improve the overall experience. For patients, preparation helps to ensure the AWV meets their expectations, as well as feels less stressful and more productive. For you and your practice, prepared patients can expedite completion of the AWV in a manner that still meets patient needs and requirements.

5 Steps to Improve AWV Preparation

Take the following five steps to improve the preparation of Medicare patients for their annual wellness visit.

Step 1: Provide patients with a summary of annual wellness visit services

Before their appointment, provide your Medicare patients with a summary of the services they will receive during the AWV. Keep the summary as short and straightforward as possible, including the key actions you will undertake, descriptions, a summary of elements, and definitions where they may be helpful. A good resource for putting such a summary together is the annual wellness visit Medicare Learning Network booklet from the Centers for Medicare & Medicaid Services.

In addition to developing a summary of AWV services, create a distinct summary of services you will provide during the initial preventive physical examination, also known as the IPPE or "Welcome to Medicare" preventive visit. Medicare covers one beneficiary IPPE per lifetime, and it must be provided within the first 12 months after the beneficiary's eligibility date for Medicare Part B benefits.

Step 2: Explain coverage of annual wellness visit and additional services

Patients should arrive for their AWV with an understanding of what Medicare does and does not cover. While Medicare covers the AWV once every 12 months, what you learn during the visit may lead you to recommend additional preventive services. Some such services that can be provided with the AWV are often not just covered, but the copay is waived for the beneficiary. Others may only be partially covered or not covered at all.

It is beneficial to prepare patients for the possibility that you will recommend services requiring them to pay out of pocket to cover some or all of the costs. Otherwise, patients may feel blindsided by your suggestion of non-covered services. It is also worth noting that you should take the time to explain why you recommend any additional services and review whether Medicare covers them or not.

Step 3: Differentiate between annual wellness visit and annual physical exam

Confusion is a surefire recipe for a dissatisfied patient. That's why Medicare patients must arrive for their AWV with an understanding that they will not be receiving an annual physical exam. A widely circulated article written by Michelle Andrews of Kaiser Health News (KHN) dives into the confusion surrounding the differences between an annual wellness visit and an annual physical (which we discussed in a previous blog).

Consider taking a proactive approach to differentiating between the services as part of your AWV patient preparation efforts. This will help you to ensure that patients' expectations are met and that they are not surprised or disappointed when the AWV does not include services they may have assumed were included.

Step 4: Help patients help you save time and improve the accuracy of documentation and services you advise by asking your Medicare patients to bring a wide range of information with them to the AWV. This includes the following:

  • Medical records, such as immunization
  • Detailed family health history
  • Complete list of medications and supplements, including over-the-counter medications, vitamins, and herbals as well as dosage details (Note: If patients express uncertainty about their ability to document this information, ask them to bring the medications and supplements with them in their original containers to the AWV.)
  • Complete list of current providers and suppliers involved in providing care, including community-based providers (e.g., personal care, adult day care, home-delivered meals)
  • List of durable medical equipment used and their suppliers
  • Completed health risk assessment
  • Top questions and concerns

You may also want to advise Medicare patients to bring a family member or friend if they have concerns about memory or a chronic condition that may require support.

Step 5: Share annual wellness visit resources

While you should be cognizant of not overwhelming Medicare patients with information prior to their AWV, it is worthwhile to assemble a range of resources that you can provide to patients to help them prepare for the visit. Such resources can include the following:

  • Forms for completion. This would include the health risk assessment and a preparation checklist (for example, this form from the Center for Practice Improvement & Innovation).
  • Explanations of why Medicare patients need an AWV. This can help ensure that patients follow through with their appointment. Here's one example of an article, published by Harvard Men's Health Watch, that explains the value of the AWV (specifically for men, in this case). Or, take a look at our resource for patients so they can learn more about the importance of the AWV. 
  • Definitions of key terms associated with the AWV. Examples include health risk assessment, personalized prevention plan, cognitive impairment, and screening schedule.
  • Frequently asked questions about the AWV. Topics you may want to address might include the purpose of the AWV; what the AWV does and does not include; differences between an IPPE, AWV, and annual physical; costs; who will provide the AWV; what patients should bring; and when Medicare beneficiaries are eligible for an AWV. Expand this list if patients ask you any new questions.

While it is worthwhile to have these resources available in printed format, also consider hosting them on your website in a visible and easily accessible location. Patients often visit the websites of their providers looking for information about upcoming appointments. This collection of resources may not only help patients find the information they need but could help cut back on calls to your office. In addition, you can proactively email or text a link to your Medicare patients that points them in the direction of these resources prior to their AWV.

Simplify the Annual Wellness Visit

Despite its seemingly straightforward purpose, completing the AWV is far from simple thanks to its complex and lengthy list of documentation requirements as well as the numerous steps required to conduct eligibility verification, perform effective outreach and intake, and complete coding and billing. One misstep can jeopardize your reimbursement, while inefficiencies can rapidly reduce your profit margin. The intuitive Prevounce software platform streamlines the AWV process so you can focus less on meeting requirements and focus more on patients and growing your practice. Schedule a demo today.

Annual Wellness Visit Toolkit

All Posts

Related Posts

List of ACA Preventive Services and CPT Codes [Prevounce Quick Guide]

This quick guide from Prevounce provides brief background information on the Affordable Care Act (ACA) and then identifies ACA preventive services and the CPT codes that correspond with each service. Along with the CPT codes, the guide identifies patient eligibility for each service. When listing all associated CPT codes would be impractical for a guide of this nature, we have provided a link to a webpage that provides the CPT codes you should use.  

Understanding the Medicare Wellness Visit Guidelines

In this blog, we'll discuss what some practitioners consider to be a pesky service: the Medicare wellness visit, also referred to as the Medicare annual wellness visit or AWV. For various reasons, the very phrase "Medicare wellness visit" can instill a sense of loathing and dread. Confusing and unclear language concerning Medicare wellness visit guidelines can leave practitioners confused, potentially resulting in missed income opportunities for practices and missed preventive care opportunities for patients. However, the downsides of skipping the Medicare wellness visit are worse: harm to your bottom line and potentially harm to your patients if they do not receive this essential service elsewhere.  

Prevounce Scholarship Announcement: Alexandra Baczynski, University of Illinois College of Medicine

Prevounce Health, creators of the Prevounce Care Coordination Platform, congratulates Alexandra (Ola) Baczynski, the recipient of the first Prevounce Preventive Health Graduate Scholarship.