The Annual Wellness Visit (AWV) is meant to review a patient’s wellness and develop a personalized prevention plan. When used as intended, an AWV provides an opportunity for physicians to improve the quality of care, assist in patient engagement, and optimize payment opportunities. Unfortunately, there are times when an AWV needs to be combined with one or more other Current Procedural Terminology (CPT) codes to help a patient manage their problems during the same visit. If not managed correctly, these “combination visits” can result in angry patients and revenue loss.

According to an article in Medical Economics, there are ways to significantly reduce the potential for issues from combination visits. The problem usually comes about when a patient is scheduled for their AWV, which has no cost or co-pay, but then has an acute problem or brings up a list of problems during the actual visit. Despite being informed that if these non-AWV-problems are addressed during this preventative encounter there will be a co-pay or additional fees, some patients might see this as what the article calls a “bait and switch, or somehow ‘padding’ your bill.”

Whether a patient feels like they’re being taken advantage of during the visit or receives a bill they forgot was coming, the end result can often be the loss of said patient’s positive word of mouth or even future business. To minimize the potential for this lost revenue, the article suggests that for chronic follow-ups, you can schedule the next visit as a problem-oriented visit and introduce the AWV as a free add-on service. This way the expectation for the visit involves the usual co-pay or other fees and the patient doesn’t feel surprised by a different outcome.

When the evaluation and management of problems is the focus of the visit, there’s a clear delineation between preventive services and the AWV screening. The AWV can then be left to its intended purpose of gaining information about the patient’s medical and family history, health risks, and specific vitals, rather than as a point of conflict for both patient and physician.