Dear Valued Provider,
Brand New Day values the care and support you provide to our members and because of this, we are pleased to inform you that you are eligible to participate in our 2024 Annual Wellness Visit (AWV) program that offers the following incentives for completing an Annual Wellness Visit (AWV)on your Brand New Day members.
AWV form submission
NON-COZEVA
Base Rate per Member
$125
Assessment of 75%+ Chronic Conditions
$25
Assessment of 85%+ Chronic Conditions
$25
Total Potential Per Member
$175
This AWV form contains unique patient health information data you should refer to during the AWV with the member.
To receive reimbursement, you must:
- Fully complete the Annual Wellness Exam Form
- Submit a copy of the completed AWV form and a progress note to Brand New Day
- Submit a copy of a completed W9 with your AWV submission. An AWV submission without a copy of your W9 will delay payments.
- Submit the form along with an electronic encounter with one of the following HCPCS codes: G0402 Initial Preventive Physical Exam, G0438 Initial AWV, G0439 Annual AWV, G0468 FQHC Initial Preventive Physical Exam
Completed AWV Forms and accompanying progress notes for 2024 dates of service must be submitted nolater than March 1, 2025, to be eligible for payment. Payments will be made quarterly, within about 45 days of the quarter end.
Please refer to the 2024 Medicare Provider Incentive document or contact your provider service representative for any follow-up questions or concerns regarding the Annual Wellness Visit program. Brand New Day would like to thank you for participating in the AWV Incentive Program.
Thank you,
Brand New Day
