medicare visits: a guide - riverside home healthcare...2019/09/20 · date last revised: 9/20/2019...
TRANSCRIPT
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Medicare Visits:
A Guide
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Contents MEDICARE VISIT TYPE OVERVIEW ..................................................................................................... 4
MEDICARE VISIT TYPE FLOWCHART .................................................................................................. 5
MEDICARE VISIT WORKFLOW .............................................................................................................. 6
CARE ASSOCIATE ................................................................................................................................. 6
1. Welcome to Medicare IPPE Visit Workflow ................................................................................ 7
2. Medicare Wellness – Initial Visit Workflow ................................................................................ 8
3. Medicare Wellness – Subsequent Visit Workflow ....................................................................... 9
4. Identifying Patients Due for Medicare Wellness – Subsequent Visit ......................................... 10
5. Denial of Medicare Visit Type Scheduling ................................................................................. 12
6. Proactive Review of Daily Provider Schedule ............................................................................ 13
7. Check-In of Medicare Visits ....................................................................................................... 14
8. Medicare Visits Scheduled via MyChart: InBasket Message and Patient Choice in MyChart .. 14
CARE TECH/NURSE ............................................................................................................................ 17
1. Medicare Wellness Visit Rooming ............................................................................................. 17
2. Welcome To Medicare IPPE Visit .............................................................................................. 17
3. Medicare Wellness – Initial Visit ................................................................................................ 18
4. Medicare Wellness - Subsequent Visit ....................................................................................... 19
PROVIDER............................................................................................................................................. 21
Medicare Wellness Visits Overview ................................................................................................... 21
Rooming/ Documentation ................................................................................................................... 21
Providers: Documenting The Welcome To Medicare Visit ................................................................ 23
Providers: Documenting the Medicare Wellness - Initial Visit .......................................................... 26
Providers: Documenting the Medicare Wellness Subsequent Visit .................................................... 28
How To Document Sickness In A Medicare Wellness Visit .............................................................. 30
BILLER .................................................................................................................................................. 31
Billing Criteria for Medicare Visits .................................................................................................... 31
APPENDIX ................................................................................................................................................. 32
A. NGSConnex .................................................................................................................................... 32
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Registration ......................................................................................................................................... 32
Login & Eligibility Information .......................................................................................................... 34
Medicare Beneficiary Identifier (MBI) Tool ...................................................................................... 38
B. Health Risk Assessment (HRA) Forms .......................................................................................... 40
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MEDICARE VISIT TYPE OVERVIEW
Welcome to Medicare IPPE Visit
• This is a new visit type that did not previously exist in Epic.
• Must schedule within the first 12 months that a patient is eligible for Medicare Part B
• There is no charge to the patient for this visit; it is covered completely by Medicare.
• This visit includes a review of the patients medical and social history related to their
health and education and counseling about preventative services.
Medicare Wellness - Initial Visit
• If the patient does NOT schedule the Welcome to Medicare Visit during the first 12
months of Medicare Part B eligibility, schedule a Medicare Initial Visit instead.
• There is no charge to the patient for this visit; it is covered completely by Medicare.
• This visit includes a review of the patients medical and social history related to their
health and education and counseling about preventative services.
Once per lifetime, patients may have EITHER a Welcome to Medicare Visit OR a Medicare
Initial Visit.
Medicare Wellness - Subsequent (Annual) Visit
• Schedule annually after EITHER the Welcome to Medicare Visit OR the Medicare Wellness
- Initial Visit has been completed.
• This appointment is for patients to discuss their plan of preventative care in the coming
year.
These Medicare visits are NOT:
• A routine visit
• A follow up
• A check up
• A time to assess and manage acute or chronic medical conditions
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MEDICARE VISIT TYPE FLOWCHART
Patient becomes
eligible for
Medicare Part B
Patient eligible
For Welcome to
Medicare IPPE
Visit
(G0402)
Patient eligible
For Medicare
Wellness – Initial
Visit
(G0438)
OR
(Only 1
per
lifetime)
Patient eligible
annually for 1
Medicare
Wellness –
Subsequent Visit
every
year and a day
(G0439)
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MEDICARE VISIT WORKFLOW CARE ASSOCIATE To ensure that the correct Medicare Visit type is selected during scheduling, whenever any of
the three Medicare visit types are selected:
… a decision tree appears which guides the user through which Medicare Visit type to schedule.
NGSConnex must be utilized to verify eligibility dates for Medicare Part B and the different
Medicare visit types by “G” code:
▪ G0402 = Welcome to Medicare Visit
▪ G0438 = Medicare Wellness - Initial Visit
▪ G0439 = Medicare Wellness - Subsequent (Annual) Visit
(Refer to “NGSConnex” in the appendix of this tip sheet)
This decision tree is based upon the definitions outlined in the Medicare Visit Type Overview
section of this tip sheet and the eligibility dates indicated in NGSConnex. If the user initially
chooses the incorrect Medicare visit type, the system will correct (or deny) the visit type being
scheduled based upon the decision tree responses.
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1. Welcome to Medicare IPPE Visit Workflow When the decision tree is answered as follows, the Welcome to Medicare visit will be
scheduled:
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2. Medicare Wellness – Initial Visit Workflow
When the decision tree is answered as follows, the Medicare Wellness – Initial visit will
be scheduled:
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3. Medicare Wellness – Subsequent Visit Workflow
When the decision tree is answered as follows, the Medicare Wellness – Subsequent visit
will be scheduled:
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When scheduling a Medicare Wellness – Subsequent (Annual) Visit, be sure to:
• Confirm reason for visit and educate patient on scope of this visit, utilizing the scripting:
“During this visit your provider will address any preventative services and complete a
health risk assessment to better fit your needs.”
• Instruct patient to bring all medications & supplements, list of any specialists, new
Medicare card, and Advanced Directives, if applicable.
• At Check-In: Inform patient that this is their free Annual Medicare Wellness Visit. Provide
Health Risk Assessment (HRA) form and ensure completion of form BEFORE patient is
taken back to exam room (this saves time in the exam room). EACH box must be checked
to qualify for reimbursement. (See sample HRA documents in appendix of this tip sheet.)
Scan the HRA into the patient’s Media Manager prior to patient being roomed so that
clinical staff has access to it.
4. Identifying Patients Due for Medicare Wellness – Subsequent Visit A. To determine when a patient is due for a Medicare Wellness - Subsequent Visit in
Epic, run the “Medicare Wellness Visit” report. This is accessed through the following
link:
http://rhbidb01.riversidehealthcare.net/Reports/report/Ambulatory%20Reports/Med
icare%20Wellness%20Visits%202018
B. Select the provider for whom you want to pull the report.
C. Enter Last Visit on or Before Date.
D. Look for the patient’s last “G” code billed- if over 1 year or never.
▪ G0402 = Welcome to Medicare Visit
▪ G0438 = Medicare Wellness - Initial Visit
▪ G0439 = Medicare Wellness – Subsequent Visit
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E. Go to NGSConnex and verify date of last billed Gcode. (Refer to “NGSConnex” in
appendix of this tip sheet.)
F. In Epic, check the patient’s future appointment desk for visits with your provider.
1. If an appointment (e.g. Office Visit) is scheduled- check to see if it should be a
Medicare Wellness-Subsequent Visit.
a. If Yes: Change appointment type and notify patient of this change at
Check-In. Utilize the following scripting:
“Your appointment for today has been changed from an Office Visit to a
Medicare Wellness Visit, as our records indicate you are due for this
Medicare visit. During this visit the provider will address any preventative
services and complete a health risk assessment to better fit your needs.
Should you have other concerns or complaints, they will be addressed
separately during this visit.”
b. If No: Notate in existing appointment note to schedule Medicare Wellness
– Subsequent Visit at Check-Out; indicate the due date for this visit type in
the appointment note as well.
2. If a Medicare Wellness – Subsequent Visit shows as a future appointment on a
date BEFORE the patient’s eligibility date, call the patient utilizing this scripting:
Outgoing call if patient is not eligible for Medicare Wellness - Subsequent Visit
“Hello, this is [your name] calling from Riverside Medical Group [insert your clinic
name here]. May I please speak with [patient name]? You are scheduled for a
Medicare Annual Wellness Visit with Dr. [name] on [date]. It appears that you
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have already received this service on [date]. This benefit is only eligible for
reimbursement once every 12 months. Is there any other concern that you would
like to address at this time? If so, you may keep this appointment and I’ll just
change the visit type to an Office Visit. Otherwise, I will need to reschedule this
appointment for when you are eligible.”
3. If no future appointment exists, call the patient to schedule one, utilizing this
scripting:
Outgoing call if patient is eligible for Medicare Wellness - Subsequent Visit.
“Hello, this is [your name} calling from Riverside Medical Group [insert your clinic
name here]. May I please speak with [patient name]? Our records indicate that
you are due for your free Annual Medicare Wellness Visit with Dr. [name] During
this visit he/she will address any preventative services and complete a health risk
assessment to better fit your needs. May I go ahead and schedule this
appointment for you?”
5. Denial of Medicare Visit Type Scheduling
If a scheduler answers “NO” to “Will this appointment be on or after the Next
(NGSConnex) Eligibility Date”, a “Results – Deny” error message will appear and the
system will not allow scheduling:
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6. Proactive Review of Daily Provider Schedule Depending on the clinic, this work may be performed by a CA or a CT.
A. Review any Follow Up appointments 1. Check to see if patient is following up on a problem visit.
a. Verify follow-up recommendations in provider’s last Office Visit notes.
b. Verify if patient has already followed up on problem visit.
c. If any problems need to be addressed, leave as a follow up visit.
2. Check encounters to confirm last date of Medicare Wellness – Subsequent visit
a. Confirm in Office Visit notes for that encounter that physical exam (PE) was
completed.
b. Confirm that Health Risk Assessment (HRA) form in Media Manager matches the
Medicare PE date of service.
B. Review any Medicare Wellness – Subsequent appointments 1. Check encounters to confirm last date of Medicare Wellness – Subsequent visit.
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2. Confirm in Office Visit notes for that encounter date of service that a PE was completed.
Additionally:
• Indicate last Medicare Wellness PE date of service on “My Sticky Note” for reference only
(Care Associates do not have access to “My Sticky Note”: only the clinical staff do).
• Run eligibility in NGSConnex to see if patient is eligible for Medicare Wellness – Initial or
Subsequent visit.
• Update visit type on appointment desk.
• Communicate with provider which patient was changed to Medicare PE so they know why it
is scheduled as a 15 minute visit.
7. Check-In of Medicare Visits 1. Verify with the patient that the reason for the visit is for their respective Medicare visit.
2. If the patient has additional concerns to be addressed outside of the Medicare visit, these
may be addressed and handled as outlined in the Provider section of this tip sheet (“How to
Document Sickness in a Medicare Wellness Visit”).
3. Be sure to update list of specialty providers in patient’s Care Team.
4. Give the patient a Health Risk Assessment (HRA) form to complete, then scan it into the
patient’s Media Manager BEFORE patient is roomed. If patient does not complete this prior
to rooming, clinical staff will have to reference the physical copy and then you will need to
scan this in when the patient Checks-Out.
8. Medicare Visits Scheduled via MyChart: InBasket Message and Patient Choice
in MyChart
Patients can schedule two of the three Medicare visits types via Mychart:
A. Welcome to Medicare IPPE. This is the visit type which can only be scheduled
within the first 12 months of Medicare Part B eligibility. When the patient self-
schedules this visit via MyChart, front desk users will receive a “Pt Schedule”
InBasket message indicating that the Visit Type “Welcome to Medicare IPPE (73)”
has been scheduled:
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B. Medicare Wellness – Subsequent. Patients are eligible for this visit every year once
either the Welcome to Medicare IPPE or the Medicare Wellness-Initial visit has been
completed. When the patient self-schedules this visit via MyChart, front desk users
will receive a “Pt Schedule” InBasket message indicating that the Visit Type
“Medicare Wellness – Subsequent (1171003101)” has been scheduled:
NOTE: When patients schedule their own Medicare visits via MyChart, front Desk
staff should utilize NGSConnex to verify the patient’s eligibility for the visit type, just
as they would if they scheduled the appointment for the patient. If the patient
incorrectly scheduled the visit type, the front desk must correct the visit type
accordingly.
C. What the Patient Sees When Scheduling in MyChart
When scheduling Medicare visits from MyChart, the patient will select the
appropriate reason for the appointment, either Medicare New Patient Wellness
Visit or Medicare Established Patient Wellness Visit:
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CARE TECH/NURSE 1. Medicare Wellness Visit Rooming
There are 3 types of Medicare Wellness visits, and in addition to your normal rooming
requirements, will have addition information you must document.
THERE ARE ADDITIONAL ROOMING REQUIREMENTS FOR EACH VISIT.
YOU WILL KNOW WHAT TYPE OF VISIT IT IS BY HOW IT IS SCHEDULED.
A. Welcome to Medicare Visit - eligible first 12 months of Medicare part B eligibility.
B. Medicare Wellness - Initial Exam
C. Medicare Wellness - Subsequent Exam
2. Welcome To Medicare IPPE Visit **ROOM PATIENT ACCORDING TO CURRENT RMG ROOMING GUIDELINES**
IN ADDITION, COMPLETE THE FOLLOWING:
From the “History” tab on the left sidebar, also complete the following:
NOTE: If the “History” tab is not visible, click on the “More” button and add “History”
(click on gold star) to add it to the left sidebar.
***ADDITIONAL COMPONENT***Address the Socioeconomic history as detailed below. Then
return to the ROOMING TAB. This only needs to be done once, then updated if/when it changes.
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You will need to complete the Medicare Hearing and Medicare Vision as below:
A. Medicare Hearing - Ask the Patient if there are any hearing problems.
B. Medicare Vision – complete a basic vision test using the vision wall chart (required for
Welcome to Medicare Visit, recommended for others)
❖ IMPORTANT: An EKG may be completed with this Welcome to Medicare Visit. This service is
covered, BUT the patient will incur an additional charge: a minimum 20% coinsurance and is
subject to the patient’s deductible, if they have one. Verify with provider BEFORE performing.
3. Medicare Wellness – Initial Visit
***ROOM PATIENT ACCORDING TO CURRENT RMG GUIDELINES***
IN ADDITION, COMPLETE THE FOLLOWING:
From the HISTORY tab on the left sidebar, please also complete the following:
NOTE: If the “History” tab is not visible, click on the “More” button and add “History”
(click on gold star) to add it to the left sidebar.
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***ADDITIONAL COMPONENT***Address the Socioeconomic history as detailed below. Then
return to the ROOMING TAB. This only needs to be done once, then updated annually, or
if/when, it changes.
4. Medicare Wellness - Subsequent Visit
**ROOM PATIENT ACCORDING TO CURRENT RMG ROOMING GUIDELINES**
IN ADDITION, COMPLETE THE FOLLOWING:
From the HISTORY tab on the left sidebar, please also complete the following:
NOTE: If the “History” tab is not visible, click on the “More” button and add “History”
(click on gold star) to add it to the left sidebar.
***ADDITIONAL COMPONENT***Address the Socioeconomic history as detailed below. Then
return to the ROOMING TAB. This only needs to be done once, then updated annually if/when it
changes.
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PROVIDER Medicare Wellness Visits Overview Within the first 12 months that a patient is eligible for Medicare Part B, patients can schedule a “Welcome
to Medicare” visit. After this period, they are eligible to schedule either a “Medicare Wellness Initial” visit
(for the first visit of this type) or a “Medicare Wellness Subsequent” visit.
Let’s make this clear. For someone coming into Medicare now, they could have each of the three visits in
the first three years of Medicare enrollment. But most of your patients are already enrolled in Medicare
and are therefore outside that initial 12-month window. Those people are eligible either for the
“Medicare Wellness Initial” (for their first appointment) or “Medicare Wellness Subsequent” visit. All
three visit types are covered completely by Medicare at no cost to the patient.
• Your registration staff and billers will help you determine which visit your patients require. There
is a report the front desk can pull and a website where they can verify eligibility.
• “Welcome to Medicare” visits only offer an EKG. This service is covered, BUT at a 20%
coinsurance, and is subject to the patient’s deductible, if they have one.
• Visits can be scheduled a year and a day apart.
Rooming/ Documentation • There are three available templates: Welcome to Medicare, Medicare Initial, and Medicare
Subsequent visits. These are set up so that when the patient is roomed correctly, and the note is
completed correctly, the visit will be paid at no cost to the patient.
• Rooming staff will follow all current rooming guidelines, but for the “Welcome to Medicare” visit
only they will additionally do a vision screening and ask a simple hearing question.
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• Rooming staff will also be asking socioeconomic information on the patient for all 3 visit types as
shown below. This needs to be done initially, then updated annually or if/when it changes. This
information will populate into your note as well.
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Providers: Documenting The Welcome To Medicare Visit
By following the outlined steps below, you will meet the documentation
requirements for the Medicare Wellness Visit. Remember:
• This visit is only for patients within the first 12 months of Medicare Part B coverage - your front
desk will have verified and checked.
• Patient is roomed according to MWV guidelines. This includes additional socioeconomic
information the rooming staff will gather.
From the notes section, select the “RMG WELCOME TO MEDICARE” note template:
Document on the visual acuity (select one):
Document the Cognitive Assessment (select one). This is a separate, paper assessment. You have the
option of using the MoCA, the Mini-Cog, or the MMSE:
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Document preventative measures (click on the tests you discuss):
Document on EKG (select one):
Document on Advanced Directives (may select multiple):
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Document whether a physical exam is being conducted. If yes is selected, the exam will populate,
and you can make changes as necessary. If you choose to use NoteWriter, there is an option to
use this as well.
Click “Accept.” Go to the “Wrap up” tab.
Wrap up the visit:
❖ You should have tabs already in the “Wrap Up” section if you haven’t customized
❖ LOS for this visit is G0402
❖ Diagnosis for this visit is Z00.00 (Wellness exam with no abnormal finding) or Z00.01
(Wellness exam with abnormal finding)
❖ Provider should also be using diagnosis codes for all chronic conditions, as required by
HCC.
❖ Indicate when the patient is due for their next Annual Wellness Exam (366 DAYS), so the
front desk staff can schedule.
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Providers: Documenting the Medicare Wellness - Initial Visit
By following the outlined steps below, you will meet the documentation
requirements:
• Patient is roomed according to MWV guidelines. This includes additional socioeconomic
information the rooming staff will gather.
• Review the Health Risk Assessment that the patient has filled out – this is a separate, paper
assessment that needs to then be scanned into the chart.
From the Notes section, select the “RMG Medicare Wellness-Initial” note template:
Document the Cognitive Assessment (select one). This is a separate, paper assessment. You have the
option of using the MoCA, the Mini-Cog, or the MMSE:
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Document preventative measures (click on the tests you discuss):
Document on Advanced Directives (may select multiple):
Document whether a physical exam is being conducted. If yes is selected, the exam will populate,
and you can make changes as necessary. If you choose to use NoteWriter, there is an option to
use this as well.
Click “Accept.” Go to the “Wrap Up” tab and complete:
❖ You should have Medicare visit buttons already in the “Wrap Up” section if you haven’t
customized
❖ LOS for this visit is G0438
❖ Diagnosis for this visit is Z00.00 (Wellness exam with no abnormal finding) or Z00.01
(Wellness exam with abnormal finding) ❖ Indicate when the patient is due for their next Annual Wellness Exam (366 DAYS), so the
front desk staff can schedule
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❖ Provider should also be using diagnosis codes for all chronic conditions, as required by
HCC.
Providers: Documenting the Medicare Wellness Subsequent Visit
By following the outlined steps below, this will meet the documentation
requirements for the Medicare Wellness Visits.
• Patient is roomed according to MWV guidelines. This includes additional socioeconomic
information the rooming staff will gather.
• Review the Health Risk Assessment that the patient has filled out – this is a separate, paper
assessment that will need to be scanned into the chart.
From the Notes section, select the “RMG Medicare Wellness Subsequent Note” template:
Document the Cognitive Assessment (select one). This is a separate, paper assessment. You have the
option of using the MoCA, the Mini-Cog, or the MMSE:
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Document on preventative measures (may select multiple):
Document on Advanced Directives (may select multiple):
Document whether a physical exam is being conducted. If yes is selected, the physical exam will
populate, make changes as necessary. If you choose to use NoteWriter, there is an option to use
this as well.
Click “Accept.”
❖ LOS for this visit is G0439.
❖ You should have Medicare buttons for LOS in your wrap up already, if you have not personalized.
❖ Diagnosis for this visit is Z00.00 (wellness no abnormal findings) or Z00.01 (wellness exam with
abnormal findings)
❖ Indicate when the patient is due for their next Annual Wellness Exam (366 days), so the front desk
staff can schedule ❖ Provider should also be using diagnosis codes for all chronic conditions, as required by HCC.
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How To Document Sickness In A Medicare Wellness Visit Document illness/sickness by opening an additional, separate note from the Medicare Wellness visit.
This note needs to have all the components for a standard visit, since an additional LOS can be dropped
for it.
❖ A new patient to you must meet all elements (for the level selected) in the History (includes
HPI/ROS/past, family & social), Exam, and Medical Decision Making (MDM).
❖ An established patient of yours must meet 2 out of the 3 elements, but must always meet the
MDM for the LOS they are selecting. The provider can meet this with either the Exam & MDM or
the History & MDM.
In Wrap-up>LOS , select the LOS wand, select “Add E/M, and enter under the Additional E/M Codes
window. It will populate both under the LOS activity.
You can also enter your 2nd LOS code in the charge capture, in the wrap up tab. Please only do one
or the other.
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BILLER • Receive claim in the Charge Review Workqueue (There is an edit in place to drop all
Medicare Wellness – Subsequent Visits into this workqueue)
1. Locate the Health Risk Assessment (HRA) form in the patient’s chart and ensures that
it is completed entirely.
2. Discuss any questions regarding HRA form with provider.
• Verify Eligibility in NGSCONNEX (see appendix of this tip sheet)
1. G0402- Eligible within the 1st 12 months of receiving Medicare Part B
2. G0438- Eligible if INITIAL VISIT outside of the first 12 months of part B eligibility.
3. G0439- Subsequent/ Yearly code
• Check EPIC/ECW to double check the last Medicare visit code that was billed (as
precaution)
• Verify that all preventatives were completed or addressed in documentation- Pneumo,
colonoscopies, prostates, etc.
• Review documentation to ensure all requirements were met (See Billing Criteria below).
Billing Criteria for Medicare Visits 1. Welcome to Medicare Visit: G0402
a. Vision and Hearing screening must be completed and documented
b. Providers must document Health Risk Assessement (HRA) form was completed
and reviewed with the patient (EVERY question on form)
c. Eligible for 1 per lifetime if performed within the first 12 months of Part B
Eligibility
2. Medicare Wellness – Initial Visit: G0438
a. Vision and Hearing screening must be completed and documented
b. Providers must document Health Risk Assessment (HRA) form was completed and
reviewed with the patient (EVERY question on form)
c. Eligible for 1 per lifetime- IF Welcome to Medicare G0402 never billed previously
3. Medicare Wellness – Subsequent Visit: G0439
a. Providers must document Health Risk Assessment (HRA) form was completed and
reviewed with the patient (EVERY question on form)
b. Eligible for 1 every year and a day.
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APPENDIX A. NGSConnex
Registration 1. Go to
https://connex.ngsmedicare.com/home/start.swe?SWECmd=Start&SWEHo=connex.ngs
medicare.com
2. Read and agree to the standard Disclaimer
3. Click “new user”
4. Read and agree to the Online Services & Web Confidentiality Agreement
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5. Create User Name (must contain 4 alpha and 3 numeric)
6. Create Password (must contain 1 alpha, 1 numeric, 1 special character, 1 uppercase, 8-
30 characters long)
7. Enter personal Information
8. Enter Organization Information
a. NPI :1417061193
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b. PTAN: 356254
c. Last 5 digits of TIN: 67726
d. Line of Business- Part B
e. State- Illinois
9. When users initially register through Connex, an approval notification request is
automatically emailed to the current Connex administrator and should not need further
action/email from you once you complete the registration process. Users do NOT need
to reach out to the administrator to inform them that they have registered.
10. If you have any problems with this process, please submit a ticket via the Riverside IS
Help Desk portal. The tickets will be worked in the order they are received and will be
resolved within 24 hours (except weekends). Please do not e-mail, call, or jabber the
administrator directly.
Login & Eligibility Information
1. Go to
https://connex.ngsmedicare.com/home/start.swe?SWECmd=Start&SWEHo=connex.ngs
medicare.com
2. Read and agree to the standard Disclaimer
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3. Enter your Username and Password; Click OK.
4. Choose Delivery Method to Multi-Factor Authentication by selecting email or text option.
Click “Send Security Code”
5. Enter Security Code once you receive it- The Security Code is good for 24 hours even with
multiple logins.
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6. Click Eligibility Tab
7. Hit Select- For RMG- Everyone reflects as “Willmington” (Yes, it is misspelled with 2 “l’s!)
8. Enter Beneficiary’s Information and select
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9. Check “Current Part B Entitlement Date”
10. Under Preventive Services, look for patient’s next eligibility date to determine when
he/she is eligible for an AWV. If “Current Part B Entitlement” and the “Next Eligibility
Date” Are the same- Patient should have a Welcome to Medicare Visit.
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Medicare Beneficiary Identifier (MBI) Tool
The MBI look up tool will help you look up the patient’s new MBI if the patient does not have
their new card available when you are speaking with them.
1. Login to NGS Connex
2. Select MBI Lookup link in the top right-hand corner
3. Select “reCAPTHA” checkbox and select the appropriate images to validate
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4. Enter at least the first 6 letters of the last name and the first letter of the patients first
name, DOB, SSN, and Group NPI
5. Select “Done”
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B. Health Risk Assessment (HRA) Forms Located on Rivernet>Forms> Medicare Wellness Check up
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Front: FOR REFERENCE ONLY
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Back: FOR REFERENCE ONLY
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Spanish Version: FOR REFERENCE ONLY