American Academy of Family Physicians

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Americans in Motion

Guide Provides Information on Conducting, Billing for Group Visits

By Barbara Bittner

The AAFP's Americans in Motion, or AIM, initiative has released a step-by-step guide to conducting and getting paid for group visits for patients with health conditions directly related to overweight and obesity, including diabetes.
Americans in Motion
"A Guide to Group Visits for Chronic Conditions Affected by Overweight and Obesity," (16-page PDF; About PDFs) provides information on encouraging patients to eat healthy foods, become more physically active and improve their emotional well-being. The guide grew out of a presentation by Steven Masley, M.D., medical director at the Masley Optimal Health Center in St. Petersburg, Fla., and clinical assistant professor at the University of South Florida, who is a co-author of the guide.

In addition to providing advice on how to plan, conduct and follow up on group visits for patients, the guide offers sample scripts for telephone calls to patients, sample invitation letters, confidentiality forms, checklists for staff members and sample progress notes. The fitness inventory developed by AIM also is included. The inventory provides a way for FPs to determine how active their patients are, their level of emotional fitness and their eating habits. After determining these three metrics, the inventory helps physicians develop a "fitness prescription" for patients.

The guide also provides information on billing for group visits. It gives specific instructions on how to bill for evaluation and management services, how to deal with Medicare and Medicaid, how to bill for services by other health care professionals, and how to bill for diabetes self-management. The guide reminds physicians who conduct group visits not to bill based on time, but rather on the "complexity of the diagnosis and your documentation."

Although busy FPs may be reluctant to invest the time necessary to conduct group visits, Masley urges physicians to rethink their approach to health care. If patients who are overweight or obese just keep getting worse, how are those patients being helped, asks Masley. "To change health care, we have to change the paradigm," he says.

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