The document discusses annual wellness visits (AWV) under Medicare and opportunities to simplify the AWV process using digital tools. It notes that while AWVs can provide a billable opportunity of around $150, the existing paper-based process is time-consuming for physicians and disrupts practice workflow. The Essia Well Check solution aims to automate AWV tasks like health assessments, screening, and personalized care plans using a HIPAA-compliant cloud-based software. This could save physicians 10+ minutes per visit and generate customized reports for billing.

1. Annual Wellness Solution
Simplifying Medicare Annual Wellness Visits

2. Annual Wellness Visits (AWV) Adoption
31,499,467
Medicare patients
4% receive AWVs
1,295,373
Source: Andy Zeigert, The Bulletin

3. Opportunities and Challenges with AWVs
• Establishing and maintaining a
personalized prevention plan
• Billable opportunity ~$150
• Standard framework to follow
• Can be billed with E/M service on
same date with -25 modifier
• A lot of administrative documentation
• Time consuming for physicians
• Disrupts practice workflow
• Excludes general exam
• Confusing requirements can result in
denials

4. Example Existing AWV Process
Practice Scheduler
Patient arrives early
to complete Health
Risk Assessment
(HRA) Questionnaire
Schedule
visit
Ask patient to
bring key
information
Review HRA
Vitals taken
Complete screening
schedule
Review HRA
Review screening schedule
Complete Risks, Results and Follow-up
Complete Personalized Health Plan
Consult patient
15 mins 20 mins 20+ mins
HRA Paper Form
Completed
HRA Paper Form
Reviewed
Screening Schedule
Form Completed
Results and Risks
Form Completed
Health Plan Form
Completed
HRA Paper Form
Reviewed
Screening Schedule
Form Completed
Patient Clinical Staff Physician
Document and
Bill

5. The Essia Well Check Solution
Patient e-Questionnaire Review summary reports
Review and complete vitals
Complete Screeners
Review summary reports
Confirm orders
Consult patient
15 mins 10 mins.
(10 min saving)
10 mins.
(10+ min saving)
Patient Clinical Staff Physician

6. Automated Solution Outputs
5-Year Personalized
Health Plan
Patient Action Plan
AWV Results and
Follow-up

7. Software Features
• Desktop, tablet and
mobile compatible
• Single cloud-based tool
for the patient and
entire care team
• Customized reports for
printout and email
• Fully HIPAA compliant
• EMR information
prepopulated
• Customizable user access
rights and privileges
• Interface designed for
simplicity
• Responsive patient
questioning
• Intelligent information
summaries
Simple, Flexible and Compliant

8. EMR Information Pre-Population
47 fields exported from EMR
.CSV upload
Intelligent data reading
Technical support is provided
Doctors and Support Services
.CSV upload
Technical support is provided
Batch Patient Upload Medical Support Upload

9. How It Works
Patient information from EMR is
reviewed, and scheduler notified of
key patient information gaps.
Patients self download health & life
circumstances through e-
questionnaire, while in waiting room.
Staff reviews e-questionnaire, inputs
necessary vitals, and downloads
results for physician review.
System codifies the visit and
produces a care packet with patient
road map & 5-year care plan.
Physician sets orders and consults
patient about care plan.
System shares visit summary and
provides documents for billing
purposes.
1 2 3
456

10. Scribe Augmented Well|Check Solution
Manages all
EMR data
uploads into
Well|Check
software
Highlights all
information
gaps to practice
scheduler prior
to patient visit
Preps software
for patient use
and initiates
patient e-
Questionnaire
Preps software
for clinician and
physician use
Prints all required
software
downloads for
patient
consultation
Completes all
required EMR
documentation
Checks
eligibility from
EMR data and
C-SNAP

11. Appendix

12. AWV FAQs
Who is eligible for an AWV?
Medicare beneficiaries 66 or older, not within the 1st
year of Medicare Eligibility, Part B / Medicare
Advantage, who haven't had an IPPE / Initial /
Subsequent AWV in the past 12 months
Who can perform AWV?
Physicians (MD / DO) Non-physician practitioners
(PA, NP, CNS) Medical Professionals (Health
educator, dietitian, nutritional professional / other
licensed practitioner or a team working under the
supervision of a physician.)
Billing codes:
CPT: G0438 (1st visit), G0439 (all subsequent visits).
Medicare will pay a physician for an AWV service
and a medically necessary service, as long as the
medically necessary service is billed with modifier.
Reimbursement Rates
National Averages are: G0438: $161 | G0439: $137
To find the exact reimbursement for your region,
refer to the Physician Fee Schedule on cms.gov

13. AWV Results Goes to the Biller
Lists the health areas in which the patient is at risk. This
information is generated based on patient self-responses
in the HRA and the assessment from the Provider
Encounter.
Findings
Services Referred
Lists the support services and referrals recommended by
the provider

14. 5-year Health Plan Goes to the Biller
Lists additional screeners recommended by the patient
based on the information provided in the Provider
Encounter.
This includes the Medicare Preventive Services, as well as
any additional services deemed appropriate by the
provider.
Personalized Health
Plans

15. Personalized Action Plan Goes to the Patient
Once the Clinician Report has been generated, the
clinician and patient will be able to create a Personalized
Action Plan
Based on 3 questions directed to identify:
• Patient health goals
• Actionable steps to achieve these goals
• Confidence in their ability to reach identified goals
Upon completion of the AWV, the care team has the
capability of completing the questions above with the
patient in the office.
Action Plan