RE: Annual Wellness Visits

[Guest guest]

IMPs

;

Anyone doing them. We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter. Can be done with E/M visit.

Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

and gang:

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

"Don't ever let injustice go by unchallenged."

[Guest guest]

We do them.  We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years.  It has really helped to keep our schedule full the past few months.  Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years.  Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount......

Pratt

 

IMPs

;

 

Anyone doing them.  We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter.  Can be done with E/M visit. 

 

 

Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

 

Subject: Burn out

To: Date: Wednesday, January 18, 2012, 9:58 AM

 

and gang:

 

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

 

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

 

" Don't ever let injustice go by unchallenged. "

 

[Guest guest]

I had one patient whose insurance only pays for a preventive every 2 years. Changed to an OV, still denied by insurance. Statement sent to patient, very difficult to collect. I am thinking if the patient doesn't appreciate the service and care, I will discharge the patient. Not a good fit.

 Wen

 

We do them.  We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years.  It has really helped to keep our schedule full the past few months.  Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years.  Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount......

Pratt

 

IMPs

;

 

Anyone doing them.  We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter.  Can be done with E/M visit. 

 

 

Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

 

Subject: Burn out

To: Date: Wednesday, January 18, 2012, 9:58 AM

 

and gang:

 

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

 

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

 

" Don't ever let injustice go by unchallenged. "

 

[Guest guest]

We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs.    We found that the new Medicare visit made this problem much worse.

Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits.  Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits.  Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual.

We realize that this is not very patient centered but feel that we're not keeping any patient from any services,   As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one.

 

We do them.  We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years.  It has really helped to keep our schedule full the past few months.  Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years.  Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount......

Pratt

 

IMPs

;

 

Anyone doing them.  We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter.  Can be done with E/M visit. 

 

 

Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

 

Subject: Burn out

To: Date: Wednesday, January 18, 2012, 9:58 AM

 

and gang:

 

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

 

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

 

" Don't ever let injustice go by unchallenged. "

 

[Guest guest]

similar hereas to  I do these but few people " qualify " -- they aren't well.I aget  tired of people who feel a comprehensive visit with all theri meds and labs  is preventive  so they should  get it free(I mean to any normal person a  physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up   Nuts!) They trun over their cards  " look I get a cbc free very yr "   " you donot need a cbc "   " But I can get one "

 sigh:) makes the  goodpoint though that with the exception of some plans grandfathered in   the  obama law requires no copay no payment out of pocket on wellness care and I pitch it to  folks though have not recalled any list aggressively

Jean

 

We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs.    We found that the new Medicare visit made this problem much worse.

Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits.  Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits.  Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual.

We realize that this is not very patient centered but feel that we're not keeping any patient from any services,   As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one.

 

We do them.  We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years.  It has really helped to keep our schedule full the past few months.  Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years.  Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount......

Pratt

 

IMPs

;

 

Anyone doing them.  We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter.  Can be done with E/M visit. 

 

 

Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

 

Subject: Burn out

To: Date: Wednesday, January 18, 2012, 9:58 AM

 

and gang:

 

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

 

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

 

" Don't ever let injustice go by unchallenged. "

 

--      MD          ph    fax

[Guest guest]

I have not done the proper research but I thought the annual Medicare physical, excluding the Welcome to Medicare Physical, was a normal physical. It’s not? Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of Sent: Thursday, January 19, 2012 8:25 AMTo: Subject: Re: Annual Wellness Visits similar hereas to I do these but few people " qualify " -- they aren't well.I aget tired of people who feel a comprehensive visit with all theri meds and labs is preventive so they should get it free(I mean to any normal person a physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up Nuts!) They trun over their cards " look I get a cbc free very yr " " you donot need a cbc " " But I can get one " sigh:) makes the goodpoint though that with the exception of some plans grandfathered in the obama law requires no copay no payment out of pocket on wellness care and I pitch it to folks though have not recalled any list aggressively We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs. We found that the new Medicare visit made this problem much worse. Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits. Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits. Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual. We realize that this is not very patient centered but feel that we're not keeping any patient from any services, As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one. We do them. We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years. It has really helped to keep our schedule full the past few months. Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years. Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount...... Pratt IMPs; Anyone doing them. We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter. Can be done with E/M visit. Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic. Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM and gang: Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help Izquierdo-Porrera MD PhDExecutive Director & Co-founder Care for Your Health, Inc Phone " Don't ever let injustice go by unchallenged. " -- MD ph fax

[Guest guest]

Agreed, but the thought of doing the Annual Wellness Exam as an add on code intrigues me as I do most of the “wellness” stuff when I see my Medicare patients anyway. What is the modifier we would use to do the Medicare Wellness Exam with a typical E & M code?P.S. I realize that coding in this way would require the patient to have a deductible and/or copay (for the original visit), but it also would raise a heck of a lot of revenue for not doing a whole lot of extra work. From: [mailto: ] On Behalf Of Sent: Thursday, January 19, 2012 8:25 AMTo: Subject: Re: Annual Wellness Visits similar hereas to I do these but few people " qualify " -- they aren't well.I aget tired of people who feel a comprehensive visit with all theri meds and labs is preventive so they should get it free(I mean to any normal person a physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up Nuts!) They trun over their cards " look I get a cbc free very yr " " you donot need a cbc " " But I can get one " sigh:) makes the goodpoint though that with the exception of some plans grandfathered in the obama law requires no copay no payment out of pocket on wellness care and I pitch it to folks though have not recalled any list aggressively We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs. We found that the new Medicare visit made this problem much worse. Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits. Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits. Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual. We realize that this is not very patient centered but feel that we're not keeping any patient from any services, As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one. We do them. We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years. It has really helped to keep our schedule full the past few months. Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years. Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount...... Pratt IMPs; Anyone doing them. We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter. Can be done with E/M visit. Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic. Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM and gang: Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help Izquierdo-Porrera MD PhDExecutive Director & Co-founder Care for Your Health, Inc Phone " Don't ever let injustice go by unchallenged. " -- MD ph fax

[Guest guest]

MCR wil pay for the -25  99213 etcn ot bunlde it if you do it yes at the same time as the wellness   what and I were getting at is the patietns point of viewBrady is right about a little extra work/most of the visit covered but

patietns who are entitled to get soemthing free get really upset with the  bill  20% of the  -25 99213 A typical messI attached a template  MLN matters thing Kath NO it ain;t a ful l physcial It is all stoopid welli ntended  but stoopid

 

Agreed, but the thought of doing the Annual Wellness Exam as an add on code intrigues me as I do most of the “wellness” stuff when I see my Medicare patients anyway. What is the modifier we would use to do the Medicare Wellness Exam with a typical E & M code?

P.S. I realize that coding in this way would require the patient to have a deductible and/or copay (for the original visit), but it also would raise a heck of a lot of revenue for not doing a whole lot of extra work.

 From: [mailto: ] On Behalf Of

Sent: Thursday, January 19, 2012 8:25 AMTo: Subject: Re: Annual Wellness Visits

   similar hereas to  I do these but few people " qualify " -- they aren't well.I aget  tired of people who feel a comprehensive visit with all theri meds and labs  is preventive  so they should  get it free(I mean to any normal person a  physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up   Nuts!) They trun over their cards  " look I get a cbc free very yr "   " you donot need a cbc "   " But I can get one "

 sigh:) makes the  goodpoint though that with the exception of some plans grandfathered in   the  obama law requires no copay no payment out of pocket on wellness care and I pitch it to  folks though have not recalled any list aggressively

Jean

  We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs.    We found that the new Medicare visit made this problem much worse.

 Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits.  Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits.  Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual.

 We realize that this is not very patient centered but feel that we're not keeping any patient from any services,   As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one.

 

 

  We do them.  We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years.  It has really helped to keep our schedule full the past few months.  Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years.  Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount......

Pratt

 

IMPs; Anyone doing them.  We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter.  Can be done with E/M visit. 

  Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

 

Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

  and gang: Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

  Izquierdo-Porrera MD PhDExecutive Director & Co-founder Care for Your Health, Inc

Phone   " Don't ever let injustice go by unchallenged. "

  

--      MD          ph    fax

--      MD          ph    fax

1 of 1 File(s)

mcr wellness visits.pdf

[Guest guest]

I hear ya! It does not make any sense why the insurances will not pay for what you do. When you take your car to the dealer, you MUST pay for everything that is done.Ardiana To: Sent: Thursday, January 19, 2012 12:28 PM Subject:

Re: Annual Wellness Visits

Okay, typical government BS. I am now so glad I don't take medicare. FYI, I am just now putting out a letter to patients saying that their insurance generally doesn't pay for "problems" at the time of the annual. For years I have done it and billed with a modifier, but more and more these are getting down graded or outright denied. So I need the extra visits, and I am no longer going to do it for free. Of course it will be a huge stink because even I think that it's stupid to not deal with an otitis or refilling your DM meds during your physical, but I don't make the rules. Now that medicare has put out these guidelines, the insurances will likely follow suit, and get even worse on this. JOY, not.

CCote

MD

To: Sent: Thursday, January 19, 2012 7:52:09 AMSubject: Re: Annual Wellness Visits [1 Attachment]

[Attachment(s) from included below] MCR wil pay for the -25 99213 etcn ot bunlde it if you do it yes at the same time as the wellness what and I were getting at is the patietns point of viewBrady is right about a little extra work/most of the visit covered butpatietns who are entitled to get soemthing free get really upset with the bill 20% of the -25 99213 A typical messI attached a template MLN matters thing Kath NO it ain;t a ful l physcial It is all stoopid welli ntended but stoopid

Agreed, but the thought of doing the Annual Wellness Exam as an add on code intrigues me as I do most of the “wellness†stuff when I see my Medicare patients anyway. What is the modifier we would use to do the Medicare Wellness Exam with a typical E & M code?

P.S. I realize that coding in this way would require the patient to have a deductible and/or copay (for the original visit), but it also would raise a heck of a lot of revenue for not doing a whole lot of extra work.

From: [mailto: ] On Behalf Of Sent: Thursday, January 19, 2012 8:25 AMTo: Subject: Re: Annual Wellness Visits

similar hereas to I do these but few people"qualify"-- they aren't well.I aget tired of people who feel a comprehensive visit with all theri meds and labs is preventive so they should get it free(I mean to any normal person a physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up Nuts!) They trun over their cards "look I get a cbc free very yr" "you donot need a cbc" "But I can get one" sigh:) makes the goodpoint though that with the exception of some plans grandfathered in the obama law requires no copay no payment out of pocket on wellness care and I pitch it to folks though have not recalled any list aggressivelyJean

We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs. We found that the new Medicare visit made this problem much worse.

Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits. Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits. Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual.

We realize that this is not very patient centered but feel that we're not keeping any patient from any services, As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one.

We do them. We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years. It has really helped to keep our schedule full the past few months. Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years. Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount...... Pratt

IMPs

;

Anyone doing them. We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter. Can be done with E/M visit.

Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic.

Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

and gang:

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

"Don't ever let injustice go by unchallenged."

-- MD ph fax

-- MD ph fax

[Guest guest]

No, it a bunch of screening health questions that should be part of the history of an H & P anyways. I may start doing these and throwing in the physical for free but no E & M's as right now I rarely get paid for physicals (more and more of my folks don't have secondaries that cover it like when I opened the office 4 years ago)) From: Kathy

Saradarian To: Sent: Thursday, January 19, 2012 8:38 AM Subject: RE: Annual Wellness Visits

I have not done the proper research but I thought the annual Medicare physical, excluding the Welcome to Medicare Physical, was a normal physical. It’s not? Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of Sent: Thursday, January 19, 2012 8:25 AMTo: Subject: Re: Annual Wellness Visits similar hereas to I do these but few people"qualify"-- they aren't well.I aget tired of people who feel a comprehensive visit with all theri meds and labs is preventive so they should get it free(I mean to any normal person a physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up Nuts!) They

trun over their cards "look I get a cbc free very yr" "you donot need a cbc" "But I can get one" sigh:) makes the goodpoint though that with the exception of some plans grandfathered in the obama law requires no copay no payment out of pocket on wellness care and I pitch it to folks though have not recalled any list aggressively We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional

copays or other out of pocket costs. We found that the new Medicare visit made this problem much worse. Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits. Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits. Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual. We realize that this is not very patient centered but feel that we're not keeping any patient from any services, As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one. We do them. We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years. It has really helped to keep our schedule full the past few months. Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years. Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount...... Pratt IMPs; Anyone doing them. We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter. Can be done with E/M visit. Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary

prevention in your clinic. Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM and gang: Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help Izquierdo-Porrera MD PhDExecutive Director & Co-founder Care for Your Health, Inc Phone "Don't ever let injustice go by unchallenged." -- MD ph fax

[Guest guest]

This is what I tell my patients: http://sdalc.org/PatientsOnly/medicare_annual_wellness_visit.html I have them do IMH and HYH as prework dts From: [mailto: ] On Behalf Of Kathy SaradarianSent: Thursday, January 19, 2012 5:39 AMTo: Subject: RE: Annual Wellness Visits I have not done the proper research but I thought the annual Medicare physical, excluding the Welcome to Medicare Physical, was a normal physical. It’s not? Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of Sent: Thursday, January 19, 2012 8:25 AMTo: Subject: Re: Annual Wellness Visits similar hereas to I do these but few people " qualify " -- they aren't well.I aget tired of people who feel a comprehensive visit with all theri meds and labs is preventive so they should get it free(I mean to any normal person a physical is a physcial what does a consumer care if they have 4 dx and 5 meds etc they get a check up Nuts!) They trun over their cards " look I get a cbc free very yr " " you donot need a cbc " " But I can get one " sigh:) makes the goodpoint though that with the exception of some plans grandfathered in the obama law requires no copay no payment out of pocket on wellness care and I pitch it to folks though have not recalled any list aggressively We already had a problem with patients wanting to address new or chronic, worsening problems at their physicals and then becoming irate when they had additional copays or other out of pocket costs. We found that the new Medicare visit made this problem much worse. Since the Medicare visit is so limited compared to what patients expect at a 'physical' and we've been unsuccessful in educating many patients about the payment issue, we now have a medical assistant trained to perform these annual Medicare visits. Any patient who requests their 'free Medicare physicial' is scheduled with the medical assistant similar to how we handle vaccination and blood pressure check visits. Any patient who requests a traditional head to toe physical exam or a problem oriented visit is scheduled with a provider as usual. We realize that this is not very patient centered but feel that we're not keeping any patient from any services, As we suspected, now that it's clear that the free annual visit is a very basic service, no one has requested one. We do them. We are sending out letters to all patients over 50 who haven't been in for a preventive exam in 2 years. It has really helped to keep our schedule full the past few months. Many insurance plans are paying for preventives as well - with no copay or deductible - but I just ran into one this week that will only pay for a preventive every 2 years. Patient is furious about it - not at us, specifically, but still asked for a discount over and above the insurance discount...... Pratt IMPs; Anyone doing them. We are encouraging every medicare patient to do an Annual wellness visit during the 1st quarter of the year. it is covered 100% no deductible and no copayment, which means stady cash flow in the first quarter. Can be done with E/M visit. Could keep cash flow steady by keeping a list of those that need the AWV each year to fill in low spot and imp-rove primnary and secondary prevention in your clinic. Subject: Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM and gang: Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help Izquierdo-Porrera MD PhDExecutive Director & Co-founder Care for Your Health, Inc Phone " Don't ever let injustice go by unchallenged. " -- MD ph fax

[Guest guest]

Many of our MA plans pay for a regular physical.   Pratt

 

, I haven't been offering AWVs, for the reasons others have outlined, but I'm desperately seeking money to stay open! Do you know if Medicare Advantage Plans pay for the same service? I guess they should have to... Most of my Medicare patients have switched over to MA plans.---Sharlene

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> Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

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> Izquierdo-Porrera MD PhD

> Executive Director & Co-founder

> Care for Your Health, Inc

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> " Don't ever let injustice go by unchallenged. "

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[Guest guest]

The have to pay for the same services. Give it a try or call your biggest MA and discuss with provider relations.

Subject: Re: Annual Wellness VisitsTo: Date: Friday, January 20, 2012, 10:52 AM

, I haven't been offering AWVs, for the reasons others have outlined, but I'm desperately seeking money to stay open! Do you know if Medicare Advantage Plans pay for the same service? I guess they should have to... Most of my Medicare patients have switched over to MA plans.---Sharlene> > > > Subject: Burn out> To: > Date: Wednesday, January 18, 2012, 9:58 AM> > > > Â > > > > and gang:> Â > Does anyone know the exact reference of the

paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help>  > Izquierdo-Porrera MD PhD> Executive Director & Co-founder > Care for Your Health, Inc > Phone >  > "Don't ever let injustice go by unchallenged." >  > > > > > > > > > -- > > > >    MD>    >    > ph   fax > >

[Guest guest]

Sharlene, as far as I know, MA plans have always paid for an annual physical using the 993** code.  This has been an interesting discussion.  I read the MLN that sent but it really doesn’t describe documentation.  What I find interesting is that my “physicals†or “annual wellness exams†have always been more about updating social, family history and prevention then a Head to toe physical which is pretty useless anyway, so I guess I am doing them.  I don’t do problem solving screening as I question my own abilities to problem solve ;-)  But really, how do you test that in a standardized way.  And I don’t ask about stairs,  hand rails or throw rugs.    When people go from 64 to 65 they don’t suddenly become old and decrepit. ( I now know that although I probably didn’t believe that when I was 20. )  I don’t even see them as age related questions but more related to mobility and function which can decline much younger or much older.  Is there more info on what info has to be recorded specifically?  Or just following USPTF guidelines? Also, Tammy, you idea sounds good but my physicals are booked for 60 minutes and to change that to a “sick†and not do the physical will cost me a lot of money with the now unused time.  I think I would prefer to try to get paid both at the same time.  Even with my routine f/u visits, patients always come with 1-2 more problems other than their chronic disease(s). Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of EglySent: Friday, January 20, 2012 2:40 PMTo: Subject: Re: Annual Wellness Visits The have to pay for the same services. Give it a try or call your biggest MA and discuss with provider relations. Subject: Re: Annual Wellness VisitsTo: Date: Friday, January 20, 2012, 10:52 AM , I haven't been offering AWVs, for the reasons others have outlined, but I'm desperately seeking money to stay open! Do you know if Medicare Advantage Plans pay for the same service? I guess they should have to... Most of my Medicare patients have switched over to MA plans.---Sharlene> > > > Subject: Burn out> To: > Date: Wednesday, January 18, 2012, 9:58 AM> > > >  > > > > and gang:>  > Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help>  > Izquierdo-Porrera MD PhD> Executive Director & Co-founder > Care for Your Health, Inc > Phone >  > " Don't ever let injustice go by unchallenged. " >  > > > > > > > > > -- > > > >    MD>    >    > ph   fax > >

[Guest guest]

FYI, I have rec'd payment from Medicare for 9921x codes with modifier -25 plus the AWV code. Funny, the AWV code was paid higher than the 99215 code, or not really funny. And, I've been paid for a 9921x, the AWV AND the G0101 and Q0091 codes for breast/GYN exam and pap. That is the most I've ever been paid by Medicare- actually made it more than worth my time. What Medicare patient doesn't have a problem to attend to that justifies some exam- bill the 9921x code. The AWV doesn't take long- particularly if you are prepared. My patient pop is tech savvy and I'm considering having them do the entire documentation themselves online before the visit. I've always incorporated preventive screening review during most visits anyway... now its being

paid for. And patients are happy because they are getting everything done. Carla Gibson To: Sent: Friday, January 20, 2012 12:40 PM Subject: Re: Annual Wellness Visits

The have to pay for the same services. Give it a try or call your biggest MA and discuss with provider relations.

Subject: Re: Annual Wellness VisitsTo: Date: Friday, January 20, 2012, 10:52 AM

, I haven't been offering AWVs, for the reasons others have outlined, but I'm desperately seeking money to stay open! Do you know if Medicare Advantage Plans pay for the same service? I guess they should have to... Most of my Medicare patients have switched over to MA plans.---Sharlene> > > > Subject: Burn out> To: > Date: Wednesday, January 18, 2012, 9:58 AM> > > > Â > > > > and gang:> Â > Does anyone know the exact reference of the

paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help>  > Izquierdo-Porrera MD PhD> Executive Director & Co-founder > Care for Your Health, Inc > Phone >  > "Don't ever let injustice go by unchallenged." >  > > > > > > > > > -- > > > >    MD>    >    > ph   fax > >

[Guest guest]

,Is the the template you are speaking of: https://www.cms.gov/MLNProducts/downloads/AWV_Chart_ICN905706.pdf ?Straz

FYI, I have rec'd payment from Medicare for 9921x codes with modifier -25 plus the AWV code. Funny, the AWV code was paid higher than the 99215 code, or not really funny. And, I've been paid for a 9921x, the AWV AND the G0101 and Q0091 codes for breast/GYN exam and pap. That is the most I've ever been paid by Medicare- actually made it more than worth my time. What Medicare patient doesn't have a problem to attend to that justifies some exam- bill the 9921x code. The AWV doesn't take long- particularly if you are prepared. My patient pop is tech savvy and I'm considering having them do the entire documentation themselves online before the visit. I've always incorporated preventive screening review during most visits anyway... now its being

paid for. And patients are happy because they are getting everything done. Carla Gibson To: Sent: Friday, January 20, 2012 12:40 PM Subject: Re: Annual Wellness Visits

The have to pay for the same services. Give it a try or call your biggest MA and discuss with provider relations.

Subject: Re: Annual Wellness VisitsTo: Date: Friday, January 20, 2012, 10:52 AM

, I haven't been offering AWVs, for the reasons others have outlined, but I'm desperately seeking money to stay open! Do you know if Medicare Advantage Plans pay for the same service? I guess they should have to... Most of my Medicare patients have switched over to MA plans.---Sharlene> > > > Subject: Burn out> To: > Date: Wednesday, January 18, 2012, 9:58 AM> > > > Â > > > > and gang:> Â > Does anyone know the exact reference of the

paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help>  > Izquierdo-Porrera MD PhD> Executive Director & Co-founder > Care for Your Health, Inc > Phone >  > "Don't ever let injustice go by unchallenged." >  > > > > > > > > > -- > > > >    MD>    >    > ph   fax > >

[Guest guest]

Straz,

You got it.

Subject: Re: Annual Wellness VisitsTo: Date: Friday, January 20, 2012, 10:52 AM

, I haven't been offering AWVs, for the reasons others have outlined, but I'm desperately seeking money to stay open! Do you know if Medicare Advantage Plans pay for the same service? I guess they should have to... Most of my Medicare patients have switched over to MA plans.---Sharlene > > >

> Subject: Burn out > To: > Date: Wednesday, January 18, 2012, 9:58 AM > > > > Â > > > > and gang: > Â > Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help > Â > Izquierdo-Porrera MD PhD > Executive Director & Co-founder > Care for Your Health, Inc > Phone > Â > "Don't ever let injustice go by unchallenged." > Â > > > > > > > > > -- > > > > Â Â Â MD > Â Â Â

>    > ph   fax > >

[Guest guest]

Put a -25 modifier on the E & M code

Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

and gang:

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

"Don't ever let injustice go by unchallenged."

-- MD ph fax

[Guest guest]

http://tinyurl.com/78jg7bgfor afp membersfrom tool box FPM under medicare headingbut I use hyh and imhlynnTo: From: dr_levin@...Date: Sat, 21 Jan 2012 19:56:37 -0500Subject: Re: Annual Wellness Visits

Does anyone have an actual template with the questionaires?

Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

and gang:

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

"Don't ever let injustice go by unchallenged."

-- MD ph fax

-- MD ph fax

[Guest guest]

Alright Lynn!!!

Missed that one don't know how but that is why I keep up with you guys.

Hope not too much snow in RI today -- lots of complaining here about 1-2 inches ice and 2 inches snow on that from last night, that's easy for you New Englanders.

You've made my day on the Medicare stuff today thought the guidelines were much worse than that.

For Medicare Advantage and Commercial plans, do the regular physicals though with -25 modifier on E & M, works ok.

Regards all, while I continue to work on Meaningful use start date for my EMR, and learning more than I ever wanted to know about printing through a hosted system.

Matt in Western PA

Solo since 2004

FP since 1988

Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

and gang: Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help Izquierdo-Porrera MD PhDExecutive Director & Co-founder Care for Your Health, Inc Phone "Don't ever let injustice go by unchallenged."

-- MD ph fax

-- MD ph fax

[Guest guest]

sorryIMH is instant medical history. Don worked closely with those guys to come up with a terrific screener that satisfies requirements for the Annual Medicare Wellness Exam. Actually I think the Annual Wellness Exam covers geriatric screening well so am reasonably content to do it, probably was doing it before but just not as systematically.Having the patient do it as prework before their apppointments or during their appointments with me makes perfect sense and has been working out wellpaid about $155 in RI, have not tried adding on the E/M but will do that next since I am doing that work already too.Hows your Health is indeed Hows Your Health.To: From: davidbfeig@...Date: Sat, 21 Jan 2012 18:54:06 -0800Subject: Re: Annual Wellness Visits

whats imh?hyh I assume is hows your health

http://tinyurl.com/78jg7bgfor afp membersfrom tool box FPM under medicare headingbut I use hyh and imhlynn

To: From: dr_levin@...Date: Sat, 21 Jan 2012 19:56:37 -0500

Subject: Re: Annual Wellness Visits

Does anyone have an actual template with the questionaires?

Burn outTo: Date: Wednesday, January 18, 2012, 9:58 AM

and gang:

Does anyone know the exact reference of the paper published in the annals regarding physician burn out? I need to cite it for a grant I a writing. Thanks for your help

Izquierdo-Porrera MD PhD

Executive Director & Co-founder

Care for Your Health, Inc

Phone

"Don't ever let injustice go by unchallenged."

-- MD ph fax

-- MD ph fax