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.

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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