2014 is the last year for physicians to earn 0.5 % incentive under PQRS and bring some extra revenue to their practice. So, if you have not yet prepared for PQRS, now is the right time to do so.

  • As this is the last year and last chance to earn PQRS incentives, it has become important for providers to meet the requirements and participate in qualified clinical data registry
  • Participation in 2014 is the basis for 2016 payment adjustment. In case physicians fail to report PQRS data to CMS, they will have to face -2% payment adjustment in 2016
  • Additionally, if an eligible professional is part of a group of 10 or more eligible professionals, he/she might lose additional 2% in Medicare Part B FFS payments

Individual measures reporting requirements have been increased by CMS. In order to receive the incentive, practices will have to report nine measures, covering approximately three National Quality Strategy (NQS) domains.

They will also have to report each measure for at least 50% of Medicare Part B FFS patients to which the measures are applicable. Not just eligible professionals, including Medicare physicians, Non-Physician Practitioners and Eligible therapists but Group practices can also qualify for incentive payments. However, they will have to meet certain criteria such as reporting 29 different quality measures.

Preparing for PQRS:

  • Preparation for PQRS will require practices to invest time in meeting criteria for satisfactory reporting guidelines, specified by CMS
  • Physicians will have to decide on PQRS measures for patient care that are relevant to their practice
  • Staff will have to be trained about reporting requirements

With workload increasing due to stringent HIPAA requirements, billing complexities, preparation for ICD-10, EHR implementation, documentation challenges and rising number of patients, practices are left with less or no time to gear up for PQRS incentive program.

How outsourcing can benefit your practice?

Providers who are unable to support these initiatives due to lack of time, money and resources are seeking help from a billing partner. A reputed billing company can prove quite effective in helping providers implement and streamline PQRS processes.

They can incorporate the initiatives seamlessly in the claim submission workflow. Billing companies have a skilled team of billers and coders who are proficient in documenting relevant quality measures on the billing form.

Billing partners like Medicalbillersandcoders.com can eliminate your headache of staff training and help you streamline the daunting process of installing and learning the PQRS system. While the incentives last, you will be able to recover the investment and gain increased Medicare reimbursement. It will also ensure that your staff establishes the process of identification and integration of PQRS data as a routine in claim submission workflow.

MBC has the largest consortium of certified medical billers and coders who will handle your revenue cycle with precision, maximizing your payments, minimizing claim denials and giving you sufficient time to concentrate on patient care.


Published By - Medical Billers and Coders
Published Date - Apr-08-2014 Back

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