Medicare Compliance & Reimbursement

6 tips to pave the way for initial Medicare physical exam.

Starting next year, Medicare will offer a new "welcome to Medicare" physical exam for patients joining the program. This means an opportunity for physicians to build their practices and a chance to safeguard their patients' wellness.
 
Physician practices could reap goodwill and reconnect with patients by reminding them of this new benefit. "It's just a great opportunity for physicians to build their practices," says consultant Jack Valancy in Cleveland Heights, OH.
 
"There's nothing wrong with advertising," says consultant W. Robert Cooper with W. Robert Cooper Associates in Peoria, IL. "Primary care doctors aren't usually involved in a typical reminder concept," but OB/Gyn physicians are accustomed to reminding patients of pap smears and breast checkups. This could be a chance for other physicians to get better at issuing reminders.

The exam won't be covered for existing beneficiaries, but it will provide a baseline for patients who are joining Medicare next year or in future years. The exam should include measurement of height, weight and blood pressure, electrocardiagram, screening for chronic conditions, counseling on health risks and referrals to other preventive services.
 
Experts offer the following tips for taking advantage of this service:   Run reports based on birth date. A medical office's front desk collects demographic information, including birth date. Periodically, offices should run a report listing every patient who was born in 1940, so they can remind those patients that they're joining Medicare and are eligible for this initial physical exam, says Valancy.   Practices also can set up a system at the front desk to notify patients of the benefit when they present their Medicare cards for the first time, notes Valancy. The only problem with this system is that patients may take months to come in to the office after they join Medicare, even if the program starts notifying people of the initial physical.   Create a unique identifier in your system for the exam. Since the "welcome to Medicare" exam will be a one-time benefit, physician practices want to avoid billing for it twice. So it's important to add a special marker for that benefit in your system, says Valancy.   For new patients, ask. If the patient isn't just new to Medicare but new to your practice as well, make sure he hasn't already received his "welcome to Medicare" exam at his previous physician's office, Valancy recommends.   Promote the new benefit. Physicians can visit senior centers and explain the Medicare rules, and mention that new Medicare patients will be entitled to this initial exam starting next year, Valancy recommends.   If a practice prints any kind of brochure, it should mention this initial exam, says Martin Blume, an [...]