Medicare Annual Wellness Visits
Let me first begin by saying how STUPID it is for primary care physicians to be turning away Medicare patients. I don’t care which moron at which medical association advised you to do so, you’re making a huge and costly mistake if you’re doing so. Medicare patients are the MOST PROFITABLE of all patients you can see in a primary care office, and it doesn’t matter if you’re in a state like New York where doctors are foolish enough to sign contracts with managed care for less than Medicare or if you’re in a state like Texas where commercial insurance pays 120% of Medicare. It is STUPID to not see Medicare in a primary care office.
If I go see a primary care physician, with my BCBS insurance, the doc may get $110 on my visit because I have no chronic disease, and I’m 58. If a Medicare patient sees a primary care doctor, the patient will more than likely have diabetes, hypertension, hyperlipidemia, anemia, osteoarthritis, etc. and if the doctor is wise enough to be following Medicare’s guidelines, then the typical visit willnet the doctor a little over $270 - FOR THE SAME TIME that the doctor spent with me.
This is true if the doctor is wise enough to be doing the evidenced based medicine services in their office that Medicare encourages doctors to do. Some are not wise enough or they’ve listened to the wrong advisor or office manager and they send everything profitable out.
Ok - ANNUAL WELLNESS VISITS. A practice seeing 25 patients a day with 40% Medicare will increase their annual income by at least $170,890 a year if they follow my advice and let an LVN or LPN do it.
If a doctor is smart, then they will have an LVN or LPN hired to do AWV (but wait, Don - those people cost money!!!) Yes - they are going to cost you about $17 per hour by the time you calculate your matching taxes and benefits - but they will generate well over $200 per hour if you use them wisely.
(I prefer to see the patients myself because I am a super-doctor and I can do the annual wellness visit at the same time as the annual exam and I can address the chronic disease the patient has). Yes - you can - but again - that is foolish in my opinion because you’re not valuing your time correctly. A primary care physician’s time is worth well over $425 per hour(that is collectable as billable will be much higher) if the practice is smart and running wisely. This means that for every hour the physician works, the practice should be collecting a little over $425 (that’s a minimum) for the direct, personal and general supervision services that are being performed and billed in that physician’s name. So - if an LVN can generate over $200 for that hour - and not interfere with the physician doing their SICK CARE at another visit - then the doctor by doing it themselves just knocked themselves out of $200. (I have seen doctor after doctor try to do it on their own and insist on losing money - but I refuse to try to fix STUPID, so I let them).
I use AWV Solutions for my clients, so that the AWV is automated, computerized and prompts the nurse to do exactly what I have recommended. By doing it the right way - the doctor also gets to bill the G0442 and G0444 for the alchohol and depression screenings, which increased the nurse’s production income by another $40 typically. I also use a cognitive testing service that increases it another $74. On top of that, I train the nurse of what questions that need to be asked in addition to the AWV standard questions, so the nurse can spot when the patient needs specific PROFITABLE diagnostic tests that will help the doctor capture catastrophic problems BEFORE they become catastrophic. This not only saves Medicare tens of thousands of dollars by performing the right kind of preventive care - but saves the patients from needing amputations, having heart attacks, suffering from sleep difficulties, taking depression meds unnecessarily, spending a lot of money each month on PPIs that they DO NOT NEED, etc… Oh yeah - it also means the typical AWV now will generate closer to $600 than the $104 they doctor is getting by doing it on their own.
So - if you want a one-on-one discussion with Don about how we recommend you do your AWVs - call us at 903 871-1172 and schedule it. It will be a Go To Meeting call and your doctor and office manager will be on the call (or Don won’t be as I need both the manager and doctor as we going to ask questions to both about the patient care) and you’re welcome to have your billing person on the call too.
Check out Don's AWV On Demand Webinar by clicking HERE!
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