Wiki Joining a HMO but having only Part A? how does that work?

[dtricia]

I a patient only has Part A showing on their actual Medicare card how does that work as far as billing annual wellness visits? Don't they have to have Part B to get that? Or is that where the HMO comes it? I am a little confused as pt is coming in for a Wellness visit and to me he should need to have Part B to be entitled.
thanks for incite.
Tricia

 

[mdeleon]

Many Medicare HMO plans offer the AWV the same as Medicare Part B. I would check with the patient's HMO to see if that is included as a benefit.

 

[haraml7]

Does the patient have ONLY traditional Medicare or does the patient have an HMO. The HMO replacement plan actually replaces Medicare. Also, what type of facility are you in. If you are in a physician's office then an AWV would not be covered with traditional Medicare, only part A. If the patient has an HMO plan then I would check the benefits on the HMO plan and see if the patient is entitled to physical Exam (preventative exam).

The G codes would not be billed for the HMO plan, and a preventative visit could still be performed. Medicare would bill for the AWV G codes.