tci Medicare Compliance & Reimbursement - 2008 Issue 10

Reader Question: Don't Count On Patient For WTM Data

'Welcome to Medicare' exam is a once-in-a-lifetime benefit Question: Recently, we've been faced with several "Welcome to Medicare" appointments that we end up not getting paid for because the patient didn't fit the strict guidelines. How can we prevent this? Answer: Beneficiaries receive coverage for the new "Welcome to Medicare" (WTM) exam (G0344, Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first six months of Medicare enrollment), only once in their lifetime -- and only within the first six months after joining Medicare. Experts offer these three good practices to help keep track of...

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