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ANNUAL WELLNESS VISIT QUESTIONNAIRE NAME___ D.O.B.___/___/___ TODAYS DATE ___/___/___Specialty PROVIDERS: List all physicians you are currently seeing or known to ALLERGY___ONCOLOGY (CANCER) ___CARDIOLOGIST
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How to fill out medicare annual wellness visit

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How to fill out medicare annual wellness visit

01
Schedule an appointment with your healthcare provider for the Medicare Annual Wellness Visit.
02
Bring your Medicare card and a list of any medications you are currently taking.
03
Be prepared to discuss your medical history and any current health concerns with your healthcare provider.
04
Your healthcare provider will perform a physical exam and review any necessary screenings or preventative services.
05
Follow up with your healthcare provider on any recommendations or care plans discussed during the visit.

Who needs medicare annual wellness visit?

01
Individuals who are enrolled in Medicare Part B are eligible for the Medicare Annual Wellness Visit.
02
This visit is recommended for Medicare beneficiaries to help prevent illness and promote overall health and well-being.
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The Medicare Annual Wellness Visit is a preventive service provided to Medicare beneficiaries to assess their health status, develop or update a personalized prevention plan, and promote overall well-being.
Any Medicare beneficiary who has had Medicare Part B for over 12 months is eligible for the Annual Wellness Visit, but it is not a requirement that they file it.
To fill out the Medicare Annual Wellness Visit, beneficiaries should visit their healthcare provider, complete a health risk assessment questionnaire, and discuss their medical history and preventive services.
The purpose of the Medicare Annual Wellness Visit is to create a preventive health plan tailored to the individual, identify health risks, and promote preventive care.
The visit should include information on the beneficiary's medical history, current medications, health risk assessment results, and recommendations for preventive services.
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