Many healthcare providers are leaving money on the table, unaware of a significant reimbursement opportunity: the Annual Wellness Visit (AWV). These valuable, yearly appointments are designed to proactively manage patient health and can significantly boost your practice’s revenue.
What is a Wellness Visit?
A Wellness Visit is a yearly appointment covered by insurance for beneficiaries enrolled for over 12 months. It’s not a traditional physical exam, but rather a focused discussion to develop or update a personalized prevention plan based on the patient’s current health and risk factors. These visits can be billed annually, typically allowing for a new visit 11 full months after the previous one. For example, a patient seen in March 2024 would qualify for another wellness visit in February 2025.
The Untapped Potential
Despite the clear benefits for both patients and practices, a surprising number of providers aren’t fully utilizing AWVs. Studies show that almost half of physician practices are missing out on this revenue stream. While the use of AWVs by Medicare recipients has increased from 16% in 2016 to 60% in 2022 đź”—, there’s still vast untapped potential. For every $175 Medicare reimburses for an AWV, there is an associated decrease in costs of around $38 per member per month (or $456 per year) đź”—. This indicates that the expenditure on primary care, facilitated by AWVs, can be a worthwhile investment, particularly for higher-risk populations.
Many doctors seem to think that annual wellness visits are separate from regular checkups, however, they can be performed at the same time. For example, a patient being seen for a level 4 visit (~$150) can still receive an annual wellness visit (~$120) and net the physician a higher end-reimbursement.
Rinova’s Solution
Imagine easily identifying which of your patients are eligible for an AWV and haven’t received one. Rinova’s advanced platform can review past patient records to flag these missed opportunities. By identifying patients who haven’t had their annual wellness visit, Rinova can suggest to providers when to perform one, ensuring you capture this valuable reimbursement and, more importantly, help your patients stay healthier. This not only streamlines your billing process but also enhances patient outcomes through consistent preventive care. Don’t let valuable revenue slip away; embrace the power of Annual Wellness Visits with Rinova AI.
