Wellness services are part of the ACA “Essential Health Benefits” requirement
“Preventive and wellness services” are part of the Essential Health Benefits required by the Affordable Care Act (ACA) for fully insured non-grandfathered health plans offered in individual and small group markets.
Due to this requirement, many provider offices may see an increase in preventive care visits because many Wellmark group plans have established wellness programs that encourage employees to visit their PCP for an annual biometric screening. Some programs offer rewards for participation. Along with these screenings, some employer groups require the data be captured and submitted using a new form called the Summit Health Screening form. The biometric data is then uploaded and made available only to members through a secure personal portal at Wellmark’s new Wellness Center on myWellmark.com.
To facilitate capturing the biometric data and uploading it to the Wellmark Wellness Center, some employers have elected to use a physician fax form.
The Summit Health Screening form lists the body measurements and biometric test results of the screening. The list includes:
- Blood pressure
- Height and weight
- Blood test with lipid panel
- Fasting glucose values
The form also includes an informed consent/authorization release, the terms of which are acknowledged by the signature of the Wellmark member (your patient). Your role will be to:
- Review for complete and accurate information.
- Check for both doctor and patient signatures.
- Fax to Summit Health at 248-864-4409.
Biometric screening data will not be shared with employers. Aggregate information, however, may be used by the employer group to design benefit and wellness programs and services that support overall better health for employees.