Created as part of the 2011 Affordable Care act, the Annual Wellness Visit (AWV) is a Medicare-covered service that enables Medicare Beneficiaries to receive an annual wellness exam at no out-of-pocket cost. The AWV is important because it allows the patient to be better connected with appropriate health services and develop a preventive health plan with their provider. The AWV is equally important to the provider because it helps to increase communication with the patient, increases patient compliance rates, and increases revenue opportunities. The AWV can be performed and billed by a physician or non-physician provider. This service must include a health risk assessment; evaluation of medical and family history; determine a current list of healthcare suppliers; review of health, cognitive, mood disorders, and functional abilities; and create a customized prevention plan for the patient.
Performing an AWV:
AWVs in Prevounce can be accessed through the “Preventative Visits” tab. Locate the desired patient and begin a new preventative visit. For further guidance on this, users can refer to the Prevounce Training - Preventative Services guide.
Once on the Preventative Visit screen for the selected patient, users will find the Annual Wellness Visit listed in the Available Assessments with the available eligibility data. To begin this service, click the “Start Service” link to the right of the eligibility data. Clicking this link will open the service wizard and begin the service. The AWV is a tabbed form with 15 individual tabs to be completed. When a tab is in progress it will be colored blue, when a tab is fully complete it will be green, and when a tab is missing crucial information, it will turn red.
The first tab (Visit Type) lists the type of AWV that is being performed. This response is very important for creating an accurate super bill when the service is completed. If the patient’s insurance is on file this section should auto-select the appropriate visit type. Click “Next” to advance to the next tab.
The second tab (Vitals) is for tracking the patient's vital signs taken at the visit. Vitals have to be recorded within the portal in order to move forward. Once the information is entered, click “Next” to advance to the next tab.
To complete the services, users will need to go through all 15 tabs with the patient. Questions annotated with a red asterisk (*) are required by CMS and will need to be answered to advance through the service.
Tabs 4 (Medications/Allergies) and 5 (Personal) contain tables that can be edited by the user. For example, in Tab 4, the Medications table lists the current medications that the patient is on. This information can be collected during Pre-Visit Outreach, during the preventative visit itself, or by communication with the practice’s EMR if there is full integration. While they all look slightly different, these tables function the same. To add a new row of information to a table, click the blue “Add [information]” button in the right above the table. This will open a wizard unique to each table to assist the user with collecting all of the pertinent information for documentation. To the left of each line item is a blue “Actions” button. Clicking this will give the user the option to either edit or delete the existing information. Medication and allergy reconciliation is a required part of the AWV; however, it can be done either in the Prevounce portal or in an EMR, or both, but CMS requires that it is completed.
Tab 14 contains the Preventative Services Schedule for the patient. This section can contain referrals, assessments, vaccinations, diagnostics, or anything else that the provider wants to suggest their patients complete. This table will automatically populate suggestions based on the history and the demographics of the patient. Suggested frequency is based on CMS guidelines but it customizable to each practice based on the preferences of the providers. These fields are also free text and can be edited for each individual patient when needed. Services can be added to the schedule by clicking the “Add Service” button in the upper left. Services can be removed from the schedule by clicking the red X to the right of the listed service.
The final tab (15) is the review and submit tab. Here the user will be alerted to any possible health risks the patient is facing that were triggered during the AWV. This page also contains a free text box for tracking notes or instructions that will appear in the Patient Report. The last section of the page contains pre-made Patient Report Attachments. These attachments are unique per practice. If there are specific attachments that a practice would like to add and implement, users should reach out to Prevounce support and the attachments can be made and put into the portal for that practice. Once all of the information has been entered, reviewed, and all tabs are green, users hit the blue “Submit” button in the bottom right of the screen which will complete the service and return the user to the Preventative Visits safe.
Users will notice that the Annual Wellness Visit will have moved from the blue “Available” section to the green “Complete” section. This means that the service is now billable within the visit. Users can see, export, or print paper records of the service by clicking the “View Report” button to the right of the completed service. This will take the user to the “Service Reports” screen where users can see all of the reports available for the AWV: AWV Doctor Summary, Full AWV Report, and AWV Patient Report. By clicking either the name of the report itself or clicking the green eye icon in the actions column, the user will be able to view a pdf preview of the report. By clicking the blue download icon users are able to download a copy of the report, which is helpful if there is not bidirectional communication between an EMR and the portal and users are manually importing the Prevounce reports into their EMR. *It is important to note that CMS requires that the patient leave with a copy of their Personalized Preventative Plan, meaning that the Patient Report will need to be printed and handed to the patient before they leave the office.
Returning to the Preventative Visits screen, users are able to perform as many services as they need to or the patient is eligible for. Once finished, users will need to complete and close the visit. In the bottom right of the page there is a “Close Visit” button. Once the visit is closed, users will be unable to add more or edit finished services. Once closed, the system will automatically generate a super bill for the visit.