FAQs for Practices
Pricing
Current subscription pricing is $720/month for up to 125 AWVs per month, or about $6 per AWV.
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Subscriptions are paid for users who conduct AWVs. Accounts can also have 1 admin with no subscription fee. Admins cannot conduct AWVs but can access reports and oversee users who administrate AWVs.
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MyCareWare also offers launch assistance for additional fees.
AWVs and Telehealth Delivery
AWVs are qualified for telehealth delivery. The process may include intake by staff, but the resulting Personalized Prevention Plan must be delivered by the physician.
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For practices on risk-adjusted programs, the AWV must be delivered by a CMS-defined qualified healthcare worker and be delivered with video, and not audio only.
Why Annual Wellness Visits
Medicare’s Annual Wellness Visits (AWV) are a great way for physicians and practices to help their patients have a better understanding of their health and risk factors for certain potential illnesses or diseases. The Personalized Prevention Plan (PPP), the patient report resulting from the AWV, helps promote prevention contributing to better health outcomes and improving patient self-management. And, as a part of value-based care, AWVs help providers expand their care services and quality of care.
Patient Benefit
Most visits are focused on an existing problem or issue. The AWV is specifically focused on prevention: determining if a patient’s current treatment plan is fully addressing their needs; determining if there are any symptoms or concerns that have not been addressed; and, identifying any potential new concerns to assure they are addressed early. Many patients feel that they can visit the doctor several times and still have things fall through the cracks. This is an opportunity to pause and assess that everything is being fully managed, and to bring issues to their doctor’s attention that may require follow-up.
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AWVs also confirm patient demographics, medical history, medications, other provider and caregiver information, assuring medical records are reviewed annually for accuracy.
What's Included
During the session, the following information is captured or completed: patient vitals; health risk assessment; list of medications; 14 health screenings; list of preventive screenings and vaccines for which the patient may be qualified; contact information; and education about Advanced Directives and other services like Chronic Care Management and Remote Patient Monitoring.
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The patient will be provided with a customized Personalized Prevention Plan, which summarizes the information collected, the patient’s screening results, and advice for helping the patient remain healthy and independent.
Patient Eligibility
Annual Wellness Visits are available annually to all patients with Medicare. Under Medicare Part B, a patient is eligible for an Annual Wellness Visit if he or she has had Medicare Part B insurance for more than 12 months and has not received an initial preventive physical exam or AWV in the last 12 months.  Most Medicare Advantage plans allow for an Annual Wellness Visits one time annually, generally anytime during the year.
Patient Billing and Coverage
Medicare pays 100% of the visit, therefore the patient does not need to be billed for their visit. We provide the practice with a billing advice that includes CPT codes, modifiers and time spent,  to assure ease of billing.
CPT Codes
G0402: The Initial Preventive Physical Examination (IPPE, aka Welcome to Medicare)
G0438 and G0439: First AWV and Subsequent AWV.
G0513 and G0514: Prolonged Preventive Service Codes (first 30 minutes and subsequent 30 minutes respectively)
99497-33: Advanced Directives
G0468: IPPE or AWV for FQHC & RHC organizations
Reimbursement
While reimbursements vary based on sequestration, locality, CPT coding, practice penalties and bonuses, and provider type, you can expect reimbursements per patient to range between $200 and $260.
DIY vs White Glove
Practices can conduct the AWV program on their own. We have tools you can download that can help you get started, and if needed, are happy to work with your team to get the program launched. One of our practices has a full-time staff member, who schedules and sees 15 patients every week for AWVs. This volume covers the staff member’s annual compensation by more than 3X.
However, many practices don’t have the time or the money to take on the entire program alone. We have a White Glove program that helps get patients scheduled and reduces staff time by conducting the intake. Some of our practices start with the full outsource solution and then, once the money starts flowing and they are confident in their ability to manage it, take the program in house.
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Whether you do it yourself, or use our White Glove services, your practice can be assured of being compliant, auditable and well trained in AWV deliveries.
Patient Sign Up
There are two primary ways: patients are directed by their providers to sign up before they leave the office; or, patients are contacted via telephone and educated about the AWV, then scheduled for their onsite or telehealth appointment. Practices can do this telephone outreach or outsource this service to our care teams.
Some practices like to drop a postcard or an email blast to qualified patients, asking the patients to schedule online or call the office for the next available appointment. This is usually followed up by an outbound calling campaign.
Typical Process
Annual Wellness Visits are completed in the doctor’s office and all follow-ups are completed by a patient’s physician and care team. The initial intake, which includes health history and assessments may be completed before the patient’s onsite office visit.
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Length of Visit
Annual Wellness Visits typically last between 45 and 60 minutes, but can last longer if patients are also enrolled in services like Chronic Care Management (CCM) or Remote Physiological Monitoring (RPM).
EHR Documentation
Patient reports are easily uploaded to your EHR, either by your staff or by our White Glove team.  Additional detail like medication lists can be added to the EHR for additional fees.
EM Billing on the Same Day
Medicare does not recommend same day services for which there may be a copay or coinsurance. Patients get confused because they were advised there would be no copay with the AWV.
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If a patient does need to be seen, we recommend making it clear that the secondary service provided will be assessed copays or coinsurance per their insurance plan.
Annual Wellness Visit vs Annual Physical Exam
Annual Wellness Visits are a question-based assessment and do not involve a physical exam of the patient.  Medicare does not cover a physical exam although some Medicare Advantage plans do.
White Glove Service Quality
To ensure quality care for your patients, we depend on 3 fundamentals:Â Â (1) software that controls the flow of the survey, limiting decision-making by staff; (2) hiring staff who are certified or qualified by their state health organizations and who are tested for clinical knowledge and patient empathy; and (3) QA, which involves listening to calls and coaching staff for continuous improvement.
What if I am not satisfied with MyCareWare?
You may cancel your subscription at any time. After cancellation, you'll have 30 days to download any patient records before we turn off access. During that 30 day window, you will not be able to conduct new AWVs.
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Our goal is satisfy you completely, so if during our relationship you have problems, please give us chance to remedy them. We're committed to your success.