Revenue program · qualifying Medicare patients only

Annual Wellness Visits, for the patients who qualify.

This is a program, not a service line. Only Medicare Part B patients past their twelve-month mark and outside their last wellness visit qualify — and two in five of them did not get one last year. We work out exactly who is eligible in your system, do the assessment before the appointment, and hand your provider a finished plan to sign.

See how many of yours are due How the cycle runs

Eligibility checked patient by patientYour schedule, your slotsPlan ready for signature

The gap this program closes

Medicare patients with an annual wellness visit, 2022.

60% had oneReceived an annual wellness visit

40% did notA covered visit and a year of gaps, left on the table

Source: CMS Medicare Current Beneficiary Survey, 2022

The economics

What a full wellness cycle is worth

An illustration, not a quote. Give us your own patient numbers and we will model it against your locality’s fee schedule.

Illustrative annual reimbursement

Example figures

Medicare patients you see

1,000

Without a visit last year (40%)

400

Recovered at a 50% booking rate

200

Annually, at ~$125 per visit

~$25,000

The 40% share is from CMS Medicare Current Beneficiary Survey (2022). The per-visit figure is an approximate national Medicare average for a subsequent annual wellness visit, rounded; the initial visit pays more and locality adjustment moves both. The booking rate shown is an assumption for the illustration, not a promise. This counts the visit alone — it excludes the downstream value of the screenings, referrals and quality measures it closes.

Who qualifies

Not every patient — three checks, run first

Commercial patients, Advantage patients on a different benefit and anyone inside their twelve-month window are all screened out before a single call is made.

12 months on Part BEnrolled in Medicare Part B for at least a year.

No wellness visit in the past 12 monthsThe benefit runs on a rolling 12 months from the last one, not the calendar year. We track the anniversary date, not the last appointment.

Past the Welcome to Medicare windowThe initial preventive physical exam cannot have been performed in the previous 12 months. Those patients are deferred, not called.

Where this program fitsAny practice carrying Medicare patients — primary care, internal medicine, family medicine, geriatrics and the primary-care arm of multispecialty groups. A practice whose patients are mostly commercial or surgical will find few qualifying patients, and we will tell you that on the first call rather than after a contract.

What is in the visit

The assessment is done before the appointment

Your provider walks in to a completed plan, not a blank form.

We complete beforehand

Health risk assessment — the questionnaire, by phone, at the patient’s pace
Medical and family history — reviewed and brought current
Cognitive and depression screening — standard instruments, scored
Chart review — every open quality gap pulled into one list
Current providers and medications — reconciled before the visit

Your provider signs

Height, weight, blood pressure and BMI recorded at the visit
A personalized prevention plan for the next 5–10 years
A preventive services checklist with due dates
Referrals and orders for whatever the gap list flagged
Documentation complete enough to survive an audit

How it runs

Starts from your patient list, not the schedule

The visit is the delivery mechanism. Closing quality gaps is the point.

Annual Wellness Visit & care gaps

Population cycle

Step 1Patient list segmentedActive, lapsed and never-engaged patients separated so outreach can differ.

Step 2Gap registryOpen screenings, overdue labs and quality measures compiled per patient.

Step 3Outreach & bookingPatients called and scheduled into wellness slots you control.

Step 4Pre-visit HRARisk assessment, history and screenings completed by phone.

Step 5Visit & planProvider reviews, signs the prevention plan, orders what was flagged.

BillingVisit billedClosed gaps post back to the registry; next year’s recall date is set.

Patients who decline or no-show return to the registry with a reason code and are re-approached on a different cadence.

Questions we get

Before you ask

Is this a physical?

No, and we say so on the outreach call. It is a prevention and risk-assessment visit. Patients who arrive expecting a head-to-toe exam are disappointed patients, so we set the expectation before they book.

Does the patient pay?

Not for the wellness visit itself when eligibility criteria are met. If a problem is addressed in the same encounter, that portion may be billed separately and normal cost-sharing applies.

Who runs the appointment?

Your clinical staff, on your schedule, in your slots. We do the finding, the calling, the assessment and the paperwork on either side of it.

What if the patient already saw us this year?

A regular office visit does not use up the wellness benefit. We check the anniversary date, not the last appointment, so nothing gets skipped or double-billed.

See what your practice is leaving on the table

A 30-minute call. Tell us roughly how many Medicare patients you see, which EMR you use and what you already run in-house. We come back with which programs your patients qualify for, what each one would take to run, and what it is likely to be worth.

Call (636) 634-1229

(636) 634-1229Mon–Fri, 8am–6pm CT

info@onpointrcm.comWe reply the same business day

201 Clarkson Executive ParkEllisville, MO 63011

Request a practice review

Same-day reply. Nothing is billed and no patient is enrolled from this form — it starts a conversation, nothing more.

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