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Report few measures to meet minimum MIPS threshold, avoid dings

10/24/2016

You’ll find relaxed reporting requirements for year one of the federal Quality Payment Program (QPP) as CMS appears to be taking a toned-down approach to kick off its new era of quality reporting.

Already reporting quality? Go big on MIPS, report full slate to gain a payment boost

10/24/2016

by: Roy Edroso and Richard Scott

While CMS set the bar low to avoid practices getting hit with a negative adjustment under MIPS, that doesn’t mean you have to settle for neutral — you can report the max number of measures and gain a 4% pay boost — or much more — in 2019.

MIPS exclusions expected to relieve 57% of providers from quality-reporting duties

10/24/2016

by: Richard Scott

As you prepare to welcome CMS’ new quality-reporting program in 2017, don’t jump out of your seat just yet – there’s a good chance you’ll be excused from taking part.

New APMs, virtual groups a MACRA rule benefit to few

10/24/2016

by: Roy Edroso

CMS is adding more advanced alternative payment models (APMs) to its list of those that can skip the requirements of the merit-based incentive payment system (MIPS), but the list remains small.

When risk adjusting, don’t skip diagnoses; note exacerbating conditions

10/24/2016

by: Roy Edroso

With almost one in three Medicare beneficiaries now enrolled in a Medicare Advantage plan, according to a Kaiser Family Foundation study, it’s useful for practices just getting started with this kind of reimbursement to understand how it works.

Coder tips from AHIMA: Cross train specialty coders and more

10/24/2016

by: Roy Edroso

A dozen coders traded tips at a physician practice coding roundtable moderated by Crystal Clack, director, HIM practice excellence for AHIMA, during the organization’s annual conference in Baltimore in October. Here are six tips from the trenches.

Watch medical necessity, conduct all tests to avoid lipid-panel denials

10/24/2016

by: Richard Scott

Ensure your documentation adds up and confirm that your provider performed all three of the tests involved in the full lipid panel (80061) to accurately report this highly-used service and avoid letting revenue slip through your fingers.

Low volume biggest reason for practices to qualify for MIPS exclusion

10/24/2016

by: Karen Long

Almost half of practices with one to nine clinicians don’t bill enough or see enough Medicare patients to be subject to the merit-based incentive payment system (MIPS) in 2017.

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