Do You Understand How Medicare Wellness Exams Work?

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| By Schristiansen
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Schristiansen
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| Attempts: 78 | Questions: 8
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1. What does "I.P.P.E." stand for? 

Explanation

The "IPPE" is a preventive exam that Medicare pays for. Medicare recipients are eligible for it for one year after the date they become eligible for Medicare. (For most people this is when they turn 65.)

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About This Quiz
Do You Understand How Medicare Wellness Exams Work? - Quiz


This is testing the feasibility of using this on-line quiz product to test (and teach) employees how to properly schedule, generate, and bill for Medicare-related well person visits.... see more see less

2. What does "A.W.V. / P.P.P.S." stand for?

Explanation

The "AWV" is the name for yearly wellness visits that Medicare pays for AFTER the first year that the patient is in medicare. The first of these visits is the "Initial AWV", each subsequent one is the "AWV - subsequent". The "IPPE" must happen within the first year that the patient became eleigible for Medicare, but the AWV's can happen any time after that first year, whether or not the patient came in for their IPPE.

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3. Mr. Jones just turned 65.  He had a 'yearly 'physical' with you 6 months ago.  Can he have his "IPPE" now?  Or must he wait till a year has passed since his last exam for Medicare to pay for his IPPE?

Explanation

Eligibility for the IPPE (I also call it the "Welcome to Medicare" exam) starts the minute he turns 65, and ends exactly a year later! It's only during this first year that a patient is in Medicare that they can have this exam. After that, they can have the "AWV". Oops! I gave the next one away!

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4. You are a scheduler. Mr. Smith is73 years old.  He wants a physical.  With just a click (well, 10 or 15 clicks) you learn that he's never had an IPPE or AWV.  You should schedule him for :

Explanation

Since Mr. Smith is way past the first year of Medicare eligibility, he can't have an IPPE. He can have an AWE, and since he's never had one before, this one will be called "Initial AWV"

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5. You are a provider. Mrs. Smith was in for her IPPE last year - she was due for a pap smear that year and had it performed.   (It was negative).  She's here today for her Initial AWV (the "Yearly medicare Follow-up exam") and wants to get "her yearly pap smear" today.  You should tell her:

Explanation

Medicare only pays for a screening pap smear every other year. So if she wants one before then, she will have to pay for that part of the exam herself.

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6. Mrs. Jones is here for her AWV - Subsequent.  But she also has a fever and a cough.  In addition to performing all the items included in the AWV, you perform evaluation and management related to her acute symptoms.  Can you submit charges for anything beyond the charge for the AWV?

Explanation

You can submit an additional charge for work done above and beyond what's in the template for the AWV. But, when calculating the charge level, be sure that you don't give yourself credit for history or exam elements that were already included in the AWV exam. Medicare doesn't like double counting!
Option D - "Ask Virginia" - is actually a good answer to this question. Ask if you are not sure!

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7. The template for the AWV is found by searching in the list of templates under:

Explanation

In the Template name list, the AWV goes under the name "Medicare Yearly Follow-up" Doesn't matter whether it's the "Initial" or "Subsequent" AWV - it's the same template. You will have to click on the appropriate quicktext at the bottom of the template to bring in the correct charge - there's one for "Initial" and one for "Subsequent".

Thank you for taking our test! Let us know if you think this is an effective way to communicate information to you.
Have a nice day!
IT dept / Med Records / SRC

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8. The template for the IPPE is found by clicking on the Template icon (upper right part of the screen) and searching for:

Explanation

Welcome to Medicare is where you'll find it. If this is hard for you to remember, let me know.

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What does "I.P.P.E." stand for? 
What does "A.W.V. / P.P.P.S." stand for?
Mr. Jones just turned 65.  He had a 'yearly...
You are a scheduler....
You are a provider....
Mrs. Jones is here for her AWV - Subsequent.  But she also...
The template for the AWV is found by searching in the list of...
The template for the IPPE is found by clicking on the Template icon...
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