Comprehensive Visit Program
We encourage our members to receive both their Medicare Annual Wellness Visit and annual physical exam each year.
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.
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
WHY IS THIS WORK IMPORTANT?
1. To promote the health of our members/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
- Access to our free disease-management programs
2. To comply with the Centers for Medicare & Medicaid Services (CMS) Medicare Advantage program requirements to validate applicable diagnosis data each year.
Generations Advantage and our network providers share responsibility for the documentation that we are required to submit to CMS regarding the health status of our members/your patients.
Our goal is to document existing diagnoses and identify diagnoses that may have been reported in error— accurately capturing the current health status of Generations Advantage members/patients.
Earn Patient-Centered Payments
Providers can earn Patient-Centered Payments for their patient's Comprehensive Visits. 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.
The Comprehensive Visit Form can be completed during one of the following visit types:
*Some of these visit types may require member cost shares.
READY TO GET STARTED?
STEP-BY-STEP SUBMISSION GUIDE
1. Complete a “Comprehensive Visit” on or before December 31st of each year.
A "Comprehensive Visit" includes both the Medicare Annual Wellness Visit and the annual physical exam.
2. Complete the required documents.
The documents required include:
- A Martin’s Point Health Care-generated “Comprehensive Visit Form” that corresponds with a previously identified member sent to you in March 2023. The form must be 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.
3. Send BOTH completed documents to Martin's Point Health Care.
We allow 60 days from the Date of Service to return the completed Comprehensive Visit Form and corresponding medical record for the 2023 qualifying visits.
The documents can be sent to us via mail, fax, or secure email using the information provided below.
MAILING ADDRESS
Martin’s Point Health Care
ATTN: Clinical Documentation
PO Box 9746
Portland, ME 04104
FAX: (207) 828-7815
SECURE EMAIL: [email protected]
Note for email submissions: 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.