Avoid reduced payments impacting your orthopedic coding, billing and collections and ultimately your bottom line when you register for the Centers for Medicare and Medicaid Services (CMS) Physician Value-PQRS (PV-PQRS) Registration System by Oct. 15, 2013. PV-PQRS is a new application to serve the Physician Value Modifier and PQRS programs that, according to CMS, will allow:
- Physician group practices to select their CY 2013 PQRS Group Reporting Mechanism and, if the group has 100 or more eligible professionals, elect quality tiering to calculate their CY 2015 Value-based Payment Modifier
- Individual eligible professionals to select the CMS-calculated Administrative Claims reporting mechanism for CY 2013 in order to avoid the PQRS negative payment
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2013 is the first year that non-participation in PQRS will result in penalties causing reduced payments impacting your practice’s healthcare revenue cycle management. While bonuses of 0.5% will be awarded through 2014, they are being replaced in 2015 with penalties for non-compliance. These penalties are scheduled to rise to 2% of total individual physician Medicare payments in 2016.
While PQRS participation is voluntary, meeting the requirements not only optimizes your practice’s revenue stream, it also demonstrates the quality care you provide. It all begins with registering and determining the right quality measure to report.
Depending on the size of your orthopedic surgery practice, at least one (if under 10) or more PQRS measures will need to be reported. Those who choose to participate individually must report on individual Physician Quality Reporting quality measures or measures groups through Medicare Part B claims, a qualified Physician Quality Reporting registry, or a qualified electronic health record. Those who choose to participate as a group can only report individual measures using a CMS-qualified PQRS registry or for groups of 25 plus eligible professionals through a web interface.
The criteria for obtaining an incentive for 2013 is as follows:
- Claims based—50 percent of applicable part B patients
- Registry based—80 percent of applicable part B patients
- EHR based—80 percent of applicable part B patients
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But which measure(s) is best for your orthopedic surgery medical revenue cycle management? This a why the right physician medical billing firm specializing in PQRS and all other orthopedic coding compliance plays a critical role. They help to select the reporting measure right for you and your practice.
Your practice may be more vulnerable with all of these new PQRS developments, unless you have an independent, third party expert in orthopedic coding and billing that’s the industry leader in PQRS compliance. revMD.com stays current on federal guidelines and changes in quality reporting measures and all other compliance areas. They protect your orthopedic medical revenue cycle management from reduced payments that will result from incomplete data reporting, whether you are a practice of 2, 20 or 200.
revMD.com is the results-proven alternative for healthcare revenue cycle management, with a niche specialization in orthopedic coding and billing that generates unprecedented results and builds profitable medical practices. Not only is revMD.com the industry expert in physician medical billing, they are the professionals in PQRS compliance and seamless ICD-10 implementation. Leveraging a history of industry wide success spanning 26 years, revMD.com partners with medical practices throughout the U.S. to optimize revenue for hospital based and practice based physicians. For more information, visit www.revmd.com.