April 2022 Newsletter

Contract & Network Update

The 2021 Wellness Visit Report is Now Available to Providers

 

The 2021 Wellness Visit Report (WVR) is now available on the ADK Share Portal. Each organization has an authorized individual with access to the ADK Share Portal who can download the report.

Background:  The WVR replaces the Annual Wellness Visit Analysis that the ACO used to distribute as part of the quarterly ACO Provider Report Package. This newest edition includes claims processed through December 2021. Payers included are Empire, Excellus, Fidelis, and Medicare.

What is WVR? The WVR lists your attributed patients (according to the payer) who…

  • are due for a wellness visit within the next six months
  • have cancer screenings due in 2022, and/or
  • had chronic (or “forever”) conditions previously coded but not coded in 2021

Report Tab 1: “Need Wellness Visit”
There are four report tabs included in the file:What is included in the WVR and why? 

  • What:  Identifies your attributed patients who are either overdue for a wellness visit or are due for one within six months.
  • Why:  This report can be used to:
    • See your payer-attributed patients who will need a wellness visit by October 1, 2022.
    • Pre-visit plan: Identify coding gaps and/or cancer screenings coming due and diabetic patients who need a current A1c.
    • Reconcile your attributed patients with the respective payers (especially for null wellness visit dates and non-users).

Report Tab 2: “Had WV; has coding gap”

  • What:  Identifies your attributed patients who are not due for a wellness visit until after October 1, 2022 but had a least one chronic or “forever” code missing in 2021.
  • Why:  This report can be used to:
    • See members who had a wellness visit as of December 2021 but had an identified coding gap.
    • Pre-visit plan: Identify chronic conditions to recapture during their next office visit and schedule cancer screenings that are coming due.

Report Tab 3: “Latest BH or OV”

  • What:  Identifies your attributed patients’ most recent behavioral health and outpatient visit service dates, locations and/or providers based on payer claims.
  • Why:  This report can be used to:
    • See where and when your patients’ behavioral health services took place.
    • Note the date of their last E&M visit at your TIN.

Report Tab 4: “Cancer screening background”

  • What:  Identifies your attributed patients’ most recent cancer screening service date, location and/or provider from payer claim, if available.
  • Why: This report can be used to: Close gaps using the included date and location of screening claims

This report is a work in progress and – as always – we invite your feedback. Please contact us if you have any questions, including identifying who at your organization has access to download the WVR.

If you have any questions or concerns, contact Lisa Cyphers.

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