Do You Understand How Medicare Wellness Exams Work?

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| By Schristiansen
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Schristiansen
Community Contributor
Quizzes Created: 1 | Total Attempts: 77
Questions: 8 | Attempts: 77

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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.


Questions and Answers
  • 1. 

    What does "I.P.P.E." stand for? 

    • A.

      "Initial Preventive Physical Exam" - the "Welcome to Medicare" exam!

    • B.

      "Infant Preventive Physical Exam" - has nothing to do with Medicare

    • C.

      "Illness Prevention Precludes Expiration"

    • D.

      "I Prefer Precooked Eggnog"

    Correct Answer
    A. "Initial Preventive Physical Exam" - the "Welcome to Medicare" exam!
    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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  • 2. 

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

    • A.

      "Annual Wellness Visit / Personalized Prevention Plan Services"

    • B.

      "Applied Warp Vector / Photon Proton Propulsion System"

    • C.

      "Actual Worm Vomit / Pasturized Pelletized Pureed Snails"

    Correct Answer
    A. "Annual Wellness Visit / Personalized Prevention Plan Services"
    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?

    • A.

      He should wait till a year after his last exam.

    • B.

      He may have his IPPE ("Welcome to Medicare exam") now

    • C.

      He can have his IPPE any time he feels like it, but no more than 5 per year

    Correct Answer
    B. He may have his IPPE ("Welcome to Medicare exam") now
    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 :

    • A.

      An IPPE, since your first Medicare "wellness" exam has to be that

    • B.

      An "Initial AWV"

    • C.

      An "AWV - subsequent" since you are confused, and just picked this randomly

    • D.

      Nothing. Since he didn't come in for his "IPPE" when he was eligible for it, he's not eilgible for any subsequent wellness visits.

    Correct Answer
    B. An "Initial AWV"
    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:

    • A.

      Sure, Medicare loves to pay for pap smears.

    • B.

      No, medicare only pays for a pap smear every other year. And only if you are a woman!

    • C.

      She can have it, but she'll have to pay for it herself

    Correct Answer
    C. She can have it, but she'll have to pay for it herself
    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?

    • A.

      Yes - you can submit a 99212, 99213, or 99214 in addition, including history elements that were included in the AWV exam to support your charge level calculation.

    • B.

      Yes, but when calculating the charge level, you can't 'double count' elements that are included in the AWV exam template.

    • C.

      Nope, you are out of luck. Ask them to come back tomorrow, and submit a separate charge.

    • D.

      Gee, this is confusing, I think I'll ask Virginia or Anne or Amber.

    Correct Answer
    B. Yes, but when calculating the charge level, you can't 'double count' elements that are included in the AWV exam template.
    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 IPPE is found by clicking on the Template icon (upper right part of the screen) and searching for:

    • A.

      Welcome to Medicare

    • B.

      IPPE

    • C.

      Medicare - Welcome To

    Correct Answer
    A. Welcome to Medicare
    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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  • 8. 

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

    • A.

      Medicare Yearly Follow-up

    • B.

      Initial AWV

    • C.

      AWV - subsequent

    • D.

      AWV / IPPE / CPAP / VRE / MRSA / ICBM Multi-template

    Correct Answer
    A. Medicare Yearly Follow-up
    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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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

  • Current Version
  • Aug 28, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • May 27, 2011
    Quiz Created by
    Schristiansen
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