Annual Wellness Visit Informational Web Page for Patients, first draft

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This is what I have been working on as a web page to educate my patients about the Annual Wellness Visit. Please help me by tearing it apart and suggesting improvements. Of course, any part you like, you are welcome to steal. I know it is too long, and that my sentences tend to run on, but I am tired of editing it today. Thanks for your help, Don The Medicare Annual Wellness Visit A new benefit offered in the Affordable Care (Healthcare Reform) Act of 2010 for Medicare patients is an " Annual Wellness Visit, " which every Medicare recipient can have once every 365 days. This benefit has no coinsurance and is subject to no deductible, so it is a significant benefit for Medicare patients. It has been described as " free. " Unfortunately, this has been promoted as an " Annual Physical Exam, " but it really is not what most people expect from a " Physical Exam, " and an actual examination of the patient or treatment of any known illness or symptoms is not included in this visit. What is included in the Annual Wellness Visit benefit?Medicare requires that providers do the following for the Annual Wellness Visit:Obtain the patient's personal and family medical historyObtain a list of healthcare providers and suppliers involved in the patient's careMeasure Vital Signs, such as blood pressure, height, weight, and waist circumferenceScreen for cognitive impairment (dementia or psychosis)Screen for depression using standardized questionnairesProvide a written schedule for each patient of government recommended screening tests and preventive services for the next 5 - 10 yearsEstablish a list of risk factors for each individual that might benefit from intervention, such as obesity, risk of falls, depression, alcohol or tobacco use, and physical inactivity. Establish a list of treatment options for these risk factors including risks and benefits of these optionsProvide personal advice regarding these risk factors, or referral to a health educator, counselor, or community-based program for lifestyle interventionsProvide advance care planning regarding end of life issues, if the patient wishesWhat is not included in the Annual Wellness Visit benefit?The Annual Wellness Visit benefit is intended for risk factor identification and preventive services planning. It is not intended to cover evaluation of symptoms or medical problems a patient may have, and it is not intended for treatment of any disease a patient may have. Examples of things not covered in the Annual Wellness Visit are:Refills of chronic medications or prescription of new medications are not includedEvaluation of status of chronic diseases such as diabetes, high blood pressure, high cholesterol, heart disease, arthritis, urinary symptoms are not includedThe actual performance of a preventive service, such as performing a Pap smear or prostate exam. (Medicare may cover these services, but they are not covered under the Annual Wellness Benefit, and are supposed to be billed separately.)An actual physical exam (such as looking at the skin, listening to the heart and lungs, examining the abdomen) are not includedBlood tests to follow any condition the patient is known to have, or blood tests to diagnose any condition except for the few specific screening tests Medicare covers. For example, Medicare covers a screening PSA (prostate cancer blood test) every year for men, but this has traditionally been subject to payment of co-insurnace and deductibles, and is not currently defined as part of the Annual Wellness Benefit. Patients with prostate cancer who need PSA tests done more often than once a year still have Medicare coverage for these tests, but the payment is not covered under the Annual Wellness Benefit.Does this mean that the doctor can't take care of my medical problems when I come in for a Annual Wellness Visit?No, nothing prevents the doctor from providing medical services or from treating illnesses on the same day as an Annual wellness visit. However, physicians are expected to bill for these services separately, and these services are subject to the patient's co-insurance and annual deductible. So, if a patient schedules an Annual Wellness Visit and needs a refill of medications or follow-up of a chronic problem or problems, the physician will submit a bill to Medicare with a service code of G0438 (for the first visit) or G0439 (for subsequent visits) and will also submit an evaluation and management service code of 99212 - 99215, depending on the time spent and complexity of the medical services offered. If a patient needs a blood draw, EKG, or urinalysis due to any medical problems, these will be billed separately, too. The services listed above as covered under the Annual Wellness Visit would be covered by Medicare without co-insurance or deductible, and the separate medical services would be subject to the co-insurance and deductible. From a practical standpoint, the Annual Wellness Visit is paid by Medicare at the same rate they pay for a 25 - 30 minute visit, and the patient is going to need to do quite a bit of pre-work before the visit for the physician to be able to meet the requirements to legitimately bill for the wellness visit. It isn't very likely that any doctor could adequately take care of more than a few chronic problems as well as the wellness visit requirements in 50 minutes, which is the maximum amount of time my schedule allows for an individual visit. So, if you are a patient who wants an Annual Wellness Visit and is on no medications, has no chronic problems, and no acute problems, please schedule a 30 minute visit and we will do the Annual Wellness Visit alone. If you have a couple of medical problems or need a refill of any medications, please schedule a 50 minute visit so we will have enough time to do the wellness exam and address a couple of your medical issues. If you are on multiple medications or have more than a couple of problems, it is most reasonable to schedule a separate visit for these issues, rather than to try to fit them into the maximum of 20 minutes that would be available on a given day beyond the time necessary for the Annual Wellness Visit. All patients will need to complete the pre-work for the exam before they are seen. This can be accomplished from home before the visit by going to these two websites: <<Insert links to IMH and HYH here>> If you are unable to accomplish this by yourself at home, and if you do not have family or friends who can help you with this, then you can come to our office a few days before your exam and do the pre-work on one of our office computers. Please contact Eva to set up a time for this. Due to our limited parking, you will need to come at a time when we do not have many other patients scheduled. Be sure to bring the names and contact information of all of your health care providers and suppliers, since this is a required part of the information that must be gathered. I am sorry that this is so complex, but Congress and Medicare did not consult me when they decided to create this benefit, and I am not allowed to bill Medicare for this service without meeting all of their requirements. Last revision: 01/28/2011