eAWV Program To Continue in 2019

x Highmark will continue to give providers the option to participate in the eAWV (Annual Wellness Visit) Program in 2019. The eAWV Program is offered through a Highmark collaboration with Vatica to providers serving our Medicare Advantage members.

Enrolled practices work with Vatica to ensure accurate and complete condition capture occurs during Annual Wellness Visits in Vatica’s eAWV solution.

NOTE: Practices enrolled in Highmark’s Unconfirmed Diagnosis Code (UDC) or Risk Score Accuracy (RSA) Programs are not eligible for simultaneous enrollment in the eAWV Program.

Program Compensation

Compensation in the 2019 eAWV Program will be awarded at $125 per completed and signed eAWV encounter for eligible assessments completed with 2019 dates. This base program compensation is in addition to the contracted fee schedule payment providers receive for performing the annual wellness visit, and is an added benefit to the providers to compensate for the additional work effort required by the eAWV Program.

Bonus compensation will be available to high-performing providers at the following thresholds:

  1. Providers that perform eAWVs for 60% of their attributed Medicare Advantage membership will receive an additional $25 (total of $150) per every completion.
  2. Providers that perform eAWVs for 75% of their attributed Medicare Advantage membership will receive an additional $40 (total of $165) per every completion.

Any bonuses earned in 2019 will be calculated in conjunction with the fourth quarter payments and paid as a lump sum in the following year. Base program payment will continue on a quarterly basis as a separate amount for eAWV services rendered, finalized, and billed each quarter.

Program Materials & Support

The program manual that supports the eAWV Program is posted on the Provider Resource Center available via NaviNet for practices to access. The eAWV Program Manual will be updated for the 2019 eAWV Program.

To access the eAWV Program Manual via NaviNet, click on Resource Center from the left workflow pane, then click on Education/Manuals from the left panel, and then click on Risk Adjustment Programs.

Please review the eAWV Program Manual for requirements and direct any questions or concerns you have to your Provider Account Liaison or the Provider Service Center at 1-800-547-3627.