When a user creates or edits an insurance's settings through the Management tab > Insurance Coverages module, each insurance coverage will contain an Insurance Benefit Option dropdown field that determines when patients associated with that insurance coverage will be considered eligible for their annual wellness exam.

The setting entered on an insurance coverage will determine the AWV eligibility for any patient associated with that insurance in their "Insurances" tab.

When a patient's insurance coverage determines that their AWV eligibility should be set to 12 months, that patient will be eligible for their next annual wellness visit exactly 12 months after their last visit was completed, regardless of the date.

To view whether or not a patient is eligible for their next annual wellness exam, a user will go to the patient's Wellness tab.

Please note, if your practice is enabled for Ability API and it returns a last completed AWV that contradicts with the date that was documented in ThoroughCare, eligibility will be calculated 12 months after the most recent AWV date occurred.

When a patient's insurance coverage determines that their AWV eligibility should be determined by the calendar year, that patient will be eligible for their next annual wellness visit on January 1st of the upcoming year after their last visit was completed.

To view whether or not a patient is eligible for their next annual wellness exam, a user will go to the patient's Wellness tab.

Please note, if your practice is enabled for Ability API and it returns an AWV dated for a year that differs from the year that was documented in ThoroughCare, eligibility will be calculated for January 1st of the most future year.

To access other helpful ThoroughCare articles in the Knowledge Base or to get help from the ThoroughCare Support team members, click the ‘i’ icon in the top right corner of the software next to the username and use the appropriate link!

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