Comprehensive Visit Program

Member/Patient Engagement: Martin’s Point encourages our Generations Advantage members to receive both their Medicare Annual Wellness Visit and an annual physical exam each year with their primary care provider. While Original Medicare only covers the Annual Wellness Visit, Generations Advantage covers both at a $0 copay.

These preventive visits serve as the primary platform for the annual assessment and documentation of each member’s health. We encourage our members to schedule these two services back-to-back in one longer appointment that we call a “Comprehensive Visit.” This affords primary care providers time to examine and develop health goals with their patients and to document the visit.

Why is this work important?

  1. To promote the health of our members/your patients: Together, the Medicare Annual Wellness Visit and the annual physical exam promote:
    • Early detection and treatment of acute and chronic conditions
    • Development of care plans to close gaps in care and meet CMS-prescribed quality measures
    • Member access to free disease-management programs we offer
  2. To comply with CMS Medicare Advantage program requirements to validate applicable diagnosis data each year: Generations Advantage and our network providers share responsibility for the documentation we are required to submit to CMS regarding the health status of our members. Our goal is to document existing diagnoses and identify diagnoses that may have been reported in error— accurately capturing the current health status of our members.
How does this work?

At the beginning of each year, Martin’s Point will send you a “Comprehensive Visit Form” for each of your qualifying Generations Advantage patients. (If you have not received a form for a qualifying patient please contact us at [email protected].)

The “Comprehensive Visit Form” will:

  • List each patient’s previously reported chronic conditions
  • Ask for verification or denial of the continued existence of each of those conditions
  • Ask for documentation of diagnoses of any other current conditions

To earn incentive payments:

  1. Complete a “Comprehensive Visit” (both the Medicare Annual Wellness Visit and the annual physical exam) on or before December 31 of each year. Note: A Generations Advantage-participating primary care provider at your practice must render the exam. The exam should include a full system review and documentation of all current conditions, severities, and comorbidities.

  2. Within 60 days of the completed “Comprehensive Visit,” send Martin’s Point Health Care BOTH of the following items:
    • “Comprehensive Visit Form”—completed, signed, and dated with updated diagnoses for ALL existing conditions
    • A copy of the completed encounter note from the patient’s EHR that provides supporting documentation - including assessment and plan - for each documented diagnosis

    Please send this information via mail, fax, or secure email.
    Mail:
    Martin’s Point Health Care
    ATTN: Clinical Documentation
    PO Box 9746
    Portland, ME 04104
    Fax: (207) 828-7815
    SECURE Email: [email protected]
    (Please put “CVF” in subject of email and use a secure, encrypted email application to send.  If you do not have access to a secure email application, please send by mail or fax.)

For information about this program
Call: 1-800-348-9804.