Verifying AWV dates through MAC


Local Chapter Officer
Best answers
I am wondering if anyone uses there local MAC to look up patients to see when they had there IPPE or Initial/Subsequent Wellness Visit? In the MLN booklet put out by Medicare it says you can check AWV eligibility information through HIPAA Eligibility Transaction System(HETS) or through the provider call center Interactive Voice Responses (IVRs).

Does anyone have experience doing this and do you feel as if it is effective? I'm trying to find a better way to make sure we are capturing the correct level of service when we do our HCCs. Noridian is our carrier.

Thank you.


Best answers
Yes, I do verify dates for IPPE and the Wellness Exams through Noridian. I actually go through the schedule in advance and put in the correct billing code on the appt notes (G0402, G0438, G0439) for our providers and it has been a great help. We were missing billing some of the IPPE's and also sometimes missing billing the initial wellness exam (which has higher reimbursement than the subsequent). Verifying has also helped catch a few here and there that were scheduled too early so we are able to reschedule them to the correct date.

I hope that's helpful. It's definitely time consuming but in the end it really makes a difference.