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How Can Physicians Manage Patients’ Annual Wellness Visit better?

What is AWV?

In the year 2011, the Center for Medicare and Medicaid Services (CMS) introduced the Annual Wellness Visit (AWV). An AWV is a yearly appointment of the patient with the physician funded by the American Affordable Care Act.  It is very different from an Annual Physical Exam and is more of an educational visit than a diagnostic one. During this visit, the physician formulates a preventive plan for the patient for the coming year. This plan can help in preventing illness based on current health and risk factors.

Eligibility Criteria

Medicare provides Personalized Prevention Plan Services (PPPS) under the wellness plan for beneficiaries who:

  • Are no longer within 12 months after the effective date of their first Medicare Part B coverage period
  • Have not received an Initial Preventive Physical Examination (IPPE) or Medicare yearly wellness visit within the past 12 months

The following medical practitioners are eligible for providing Medicare yearly wellness visit services to patients:

  • Physician (a doctor of medicine or osteopathy)
  • Qualified non-physician practitioner (a physician assistant, nurse practitioner, or certified clinical nurse specialist)
  • Medical professional (including a health educator, registered dietitian, nutrition professional, or other licensed practitioners), or a team of medical professionals who are directly supervised by a physician (doctor of medicine or osteopathy)

Medicare Wellness checklist

  1. Initial Annual Wellness Visit – This is applicable the first time a beneficiary receives an Annual Wellness Visit. It includes the following components:
  • Acquire Beneficiary Information: The physician assesses the health risk factors of the patient. It includes analyzing patient self-reported information, demographic data, daily activities, etc. He/She collects data from the list of physicians who regularly treat the patient. The physician reviews the beneficiary’s medical and social history,  completely studies the patient’s potential risk factors, mood disorders, functional ability and level of safety.
  • Begin Assessment: The physician begins the assessment by measuring the patient’s vitals. He/She identifies the patient’s illness through direct observation, medical history, concerns raised by family members, friends, caretakers, etc.
  • Counsel Beneficiary Action: The physician establishes a written screening schedule for the beneficiary, such as an appropriate checklist for the next 5 to 10 years, etc. He/She furnishes personalized health advice to the beneficiary and generates appropriate referrals to specialist clinics or imaging centers. The physician gives advance care planning at the discretion of the beneficiary.

The subsequent Medicare yearly wellness visits include the above components and will be updated on the later patient visits.

Billing Codes for Medicare Yearly Wellness Visit

G0438 $117 Annual wellness visit which includes a personalized prevention plan of service (PPS) and the first visit
G0439 $173 Annual wellness visit which includes a personalized prevention plan of service (PPS) and the subsequent visits

Tips for physicians to benefit from Annual Wellness Visit

  • Managing patients – All Medicare Part B patients are eligible for Wellness Plan services. It is necessary for the practice to find the right patients who would benefit from this service. The physicians must give the patients a clear idea of how Medicare Wellness Program process works, what they can expect from the service, etc. The practice must make the patients aware of the reimbursements and the additional charges they may incur depending on their insurance coverage.
  • Developing protocols for schedules – A Medicare Wellness Program takes a great deal of both staff and physician resources to give the service. It is better for a practice to take some time to decide how these appointments best fit into their existing schedule. Creating a scheduling protocol will save more time and frustration. For example, how many days in a week, the practice can schedule these appointments, what tool for tracking the Medicare Wellness Program services, patient records, reimbursement rates, etc.
  • Pre-visit planning – The practice must verify not only the patient’s Medicare Part B effective date but also whether the patient has received a Wellness Plan from any physician in the last 11 months. Otherwise, Medicare may deny the service, leaving the patient with an unexpected bill. The practice must do the same verification for other preventive services that patients receive along with the Medicare Yearly Wellness Visit. It is ideal to have the staff note the last date of these preventive services on a Medicare Yearly Wellness Visit documentation form in advance of the visit. This will help in determining which preventive services are needed and whether the patient is eligible to have these paid for by Medicare. A pre-visit history can also find whether the patient needs any laboratory tests such as the cardiovascular scans, diabetes screening blood tests, etc. These should be completed prior to the Medicare Yearly Wellness Visit to allow discussion of its results at the visit.
  • Planning for effective follow-up care – The physician should analyze the patient’s risk factors and problems accurately during the Medicare Wellness Program. The physician must generate a care plan for the patient considering these factors. It is necessary to develop a preventive service plan and a general checklist for the next ten years. The physicians should follow-up the same on the patient’s subsequent Medicare Yearly Wellness Visits.
  • Getting complete reimbursements – The last step in providing the Medicare Yearly  Wellness Program is to get paid the service rendered. AWV attracts the physicians’ attention because of the reimbursements offered by Medicare. The practice must keep up a clear documentation to make the process hassle-free.

These practices simplify the Medicare Wellness Program process thereby improving the efficiency of the practice. The HealthViewX solution eases the AWV workflow for the practice. With HealthViewX solution, there is no chance of losing the reimbursements. To know more about HealthViewX solution, schedule a demo with us.

Why Should A Physician Share A Good Relationship With The Patient?

 A physician attends to many patients in a day. But for a patient, the major concerns are about the severity of the illness, the quality of the treatment, etc. Patients expect the physician to diagnose the problem accurately and wants the best care possible. The ultimate goal is to get relieved of the illness as soon as possible. The physician must be interactive with the patient and it is important for the patient to cooperate with the physician to recover soon. So the relationship a physician shares with his patients is very important.

Factors affecting the physician-patient interaction

A patient wants to be taken care of and be able to frequently communicate with the physician. The physician also likes to engage with his patient and make the treatment easier but it is not easy always. So what are the factors that affect the interaction between the patient and the physician?

  • Physicians get busy – Physicians are always busy. Remembering the diagnosis of every single patient is close to impossible. He might forget what the patient is suffering from and will ask the same questions to the patient which can annoy the patient. The physicians being busy may not always follow-up with the patient. Instead, the physician will have a nurse to do that for him.
  • No effective modes to communicate – The system of care is still stuck with paperwork and following up or interacting with the patient is more of a documentation work than inquiring his well-being. There are no effective means to communicate with the patient. Following up manually is always prone to errors and leads to patient dissatisfaction.
  • Unable to reach physicians – Patients may always have to come to the hospital for even small problems as the physician is unavailable over phone calls or messages. It makes it difficult for the patient to get in touch with the physician every now and then.

These factors lead to care fragmentation and affect the health of the patients and also damage the reputation of the provider. Care fragmentation will ultimately lead to frustration between the patient and the provider.

Tips to strengthen physician-patient relationships

Following are five tips to strengthen physician-patient relationships,

  1. Follow-up appointments
  2. Get Feedback
  3. Being available at all times
  4. Staying in touch
  5. Embracing Technology
  • Follow-up appointments – Scheduling follow-up appointments with a patient after discharge is very essential for continued conversation between doctor and patient. It can help in having a check over patient’s health and also improve physician-patient relationships. Follow-up appointments need not be a  face-to-face visit always. The physicians’ can follow-up with their patients through audio or video calls eliminating the effects of poor communication in healthcare. A software to manage appointments and patient demographics can be a very useful physician communication strategy.
  • Get feedback – A lesser known tip for strengthening physician-patient relationships is by getting feedback from the patients. Feedbacks can be taken through a patient survey on the quality of care and treatment, phone calls, personal conversation with the patients, etc. Feedbacks can be useful in improving patient-physician relationship, knowing how good the service is and the areas for improvement.
  • Being available at all times – The physician must be available over calls or messages. This will make it easy for the patients to reach out to the physicians at the time of need. A nurse can also assist and bring it to the doctor’s attention if required.
  • Staying in touch – Though there are no appointments scheduled with the patient, it is always good to have a team of nurses following up with such patients occasionally. This will make the patient feel good about the physician and thus the patient-physician relationship will improve.
  • Embracing Technology – Technology is simplifying healthcare. With the help of a software, scheduling follow-up appointments, improving network connections, getting feedback from the patients, marketing a hospital, etc are made easy.

What HealthViewX solution offers?

HealthViewX Care Management Solution can help the physicians to check on their patients’ health even after hospital discharge. It results in effective communication within the practice and also between the provider and the patient thus improving the physician-patient relationship. The following are the key aspects of HealthViewX Care Management Solution.

  • Care plans to enable remote care – A provider can create a care plan for a patient depending on the vitals, treatments, measurements, etc that need to be tracked. The patient-centric application helps in logging data for the vitals specified in the care plan. If needed the care plan can also be printed.
  • Customizable dashboards to suit the need – Dashboards comprising of graphs and tables show a comprehensive data of the number of patients in different care plans depending on the patient diagnosis.
  • Scheduler to keep track of the appointments – An inbuilt scheduler keeps track of the appointments and sends timely reminders to both the patient and the provider. The chances of missing out an appointment are very less.
  • Audio and video calling features – HealthViewX Care Management solution support inbuilt audio and video calling features which help in connecting with the patients for follow-ups.
  • Patient-reported data – Patients can record data for all attributes in the care plan. Summary graphs and table data helps the providers in monitoring the patient vitals. The patient records can be anytime printed in pdf or excel report form. 
  • Health device integration – HealthViewX Care Management solution can integrate with any wearable device like Fitbit, apple watch, etc. Hence the patients need not waste time in logging data in the application if they are already using wearables.

HealthViewX Care Management Solution provides real-time communication between the patients and the providers thus enhancing the relationship between them. Schedule a demo with us to know HealthViewX HIPAA compliant Care Management solution better.