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Image from www.phreesia.comOne of your biggest opportunities for new revenue in 2011 and beyond is Medicare’s new annual wellness visit (AWV). One of the biggest obstacles to billing the AWV quickly and efficiently has been finding the right form for the visit, which is unlike a regular physical. Now some vendors are catching on and offering ways to cut physician time by digitizing the new encounter form needed to bill the AWV under Medicare guidelines.

DecisionHealth stock photoThe new annual wellness visits for seniors received acclaim on Capitol Hill Wednesday and its success could mean a revenue boost for your practice. Sen. Max Baucus (D-Mont.) boasted of the Medicare program’s success and potential overall cost reduction in a Senate Finance Committee hearing on the progress of new benefits and programs enacted by The Affordable Care Act, according to a media release.
CMS has issued a reminder that annual wellness visit (AWV) services rendered in the hospital setting (inpatient or outpatient) will be held by contractors and not paid until April 3. This only applies to AWVs that are billed alone on a claim; when the AWV is billed with another service, the entire claim will be processed, the agency says. The reason is that Medicare contractors must update their claims processing systems; they won't be ready to process standalone AWVs until April 3.
If you received a denial on your annual wellness visits (AWVs) on your first round of remittance advices for 2011, it could take until mid or late March for affected carriers to pay you back. At least one carrier that experienced the issue -- which caused their systems to automatically deny many AWVs -- gave me the mid-late March date. That would be First Coast Service Options, with jurisdiction over Florida, Puerto Rico and the U.S. Virgin Islands. First Coast officials also revealed that around 1,000 claims were impacted.
 
A federal judge in Florida on Monday ruled the Patient Protection and Affordable Care Act (PPACA) is unconstitutional. This action, however, won’t eliminate sections of the bill already implemented by CMS. You can keep providing annual wellness visits and waiving copays and deductibles for certain preventive services covered by Medicare.

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