Increased Practice Revenue
Prevounce helps get you paid to keep your patients healthy.
Each Preventative Service performed through Prevounce is billable directly to Medicare or private insurers. Although numbers vary between practices, an average office can expect reimbursement for each visit of $120-$350. This is in addition to revenue from your normal office visit for the patient.
Each Insurance Type treats Preventative Services differently:
Medicare actively promotes and publishes its support for Preventative Services, including all of those offered by Prevounce. The majority of Preventative Services are deductible and co-pay waived under Medicare.
You can view the payment amounts for all Medicare services directly in the Medicare Provider Payment Schedule. An excerpt of which is below.
PPOs and EPOs
PPO insurances have been increasingly covering preventative services over the last five years. Part of this is due to the Affordable Care Act, which mandated coverage for many of the services in Prevounce with fully waived co-pays.
PPOs do not directly publish a fee schedule, but you can expect PPOs to pay around 1x to 2.5x Medicare depending on your location and if you have any contracts with the specific PPO.
Most State Medicaid programs cover the majority of Prevounce preventative services.
For the 33 states that expanded Medicaid under the Affordable Care act, they are required to have coverage for most Prevounce offered services.
The other 18 states that did not expand their Medicaid programs generally still have coverage for preventative services, but which they will pay for varies from state to state.
If you have specific questions about your state Medicaid program, be sure to contact us at email@example.com!
HMOs and ACOs
We are always looking for new HMO partners to make use of our innovative and intuitive software!
If you are an HMO or other managed care organization, Prevounce can increase your quality of care, reduce your preventative medical costs and save you time. Enterprise level Prevounce installations also offer direct integration into your EMR and software billing solution.
Contact us at firstname.lastname@example.org or via our live chat for more information or to schedule a demonstration.
Medicare Fee Schedule
This table shows an excerpt from the 2018 Medicare National Physician Fee Schedule for a sample of preventative services available in Prevounce. The vast majority of Prevounce preventative visits include three or more services, depending on patient eligibility, demographics, insurance and other factors.
PPO insurers often base their reimbursement on the Medicare fee schedule. You can expect PPO reimbursement on covered preventative services to be around 1x to 2.5x Medicare.
Keep in mind that there are many factors that go into reimbursement amount - to see your specific practice reimbursements you should consult the Medicare website!
|Preventative Service||Low Medicare||High Medicare|
|Initial Preventative Exam||$169.92||$201.15|
|Initial Annual Wellness Visit||$175.32||$208.11|
|Subsequent Annual Wellness Visit||$119.16||$143.23|
|Advance Care Planning||$86.64||$172.70|
|Alcohol Misuse Screening||$18.72||$23.24|
|Alcohol Abuse Counseling||$26.28||$30.15|
|Tobacco Cessation Counseling||$14.76||$32.24|
|Cognitive Impairment Screening||$65.50||$103.61|
|Chronic Care Management (Monthly)||$40.30||$90.20|
Estimate Your Practice Revenue with Prevounce
How many patients does your practice see a day on average?
What Percentage of those patients are enrolled in Medicare or Mediaid?
Select the Prevounce Services that would be utilized by the practice.