PQRS – How 4 letters affect your Practice
Unless you are billing the right set of PQRS codes on 50% of your qualifying visits, then you will lose 2% of your allowed reimbursement. Learn about the changes that this reporting system brings to your practice. Understand how this reporting system affects your reimbursements plus know how and when to use these codes. Read the transcript: Jess: All right. Thank you everyone for joining us today for our webinar on PQRS. Today’s instructors are Kathleen Casbarro and David Alben [SP]. Kathleen is the head of our Billing SWAT department here at Vericle and she has 30 years of experience in this industry. And she is a certified coder. David Alben helps practices achieve and maintain a culture of compliance. He is alsot he also assists healthcare attorneys in defending their clients who have been audited or are subject to prepayment review. So he has his finger on Medicare’s expectations and when it comes to medical documentation. So welcome, Kathleen and David. Kathleen: Thanks so much Jess [SP], really appreciate that. So welcome everybody. I was told about some of the people that registered, and I’ve seen some familiar names. So I’m really glad you’re able to spend a half an hour with us today. So our focus today is going to be on PQRS. We have a single learning objective for today and that is really understanding the PQRS requirements and, you know, Medicare’s rules and the cost of PQRS to your practice. So there could be several of you on the phone that say to yourself, “Well, what is PQRS? What does it stand for? You know, why do I have to go ahead and report another set of claims to the insurance company? I mean, it just sounds like there’s a lot to juggle.” What we wanna talk to you about is, first off, is what is PQRS? So PQRS stands for the Physician Quality Reporting System. It was actually renamed from the Physician Quality of Reporting Initiative. So it used to be PQRI, if anybody familiar with that, and now it’s PQRS. They changed the acronym. The reason why we have PQRS is CMS is wants to make sure that, you know, the patient is getting the right care, that you’re providing the quality of care to your patient. And they wanna make sure that the patients are getting the right care at the right time. That’s what this system is actually built. It was actually built for reporting outcomes. The other thing that they wanna do, too, and Dave is really here to talk about that, I brought Dave on really for the auditing part of this, is, you know, quantifying how they’re meeting the particular quality measure. And Dave, how do you suggest the practice does that? David: So I think it’s important to, first up, really understand what Medicare is looking for, which we’re talking about today. And the other aspect of it is that you pretty much have to patrol your own house, keep it in order, auditing your own claims to make sure that you’re meeting the standards and the number of claims that you need to report on on a…at least a quarterly basis, maybe a little more frequently at the beginning and that everyone on your team understands the significance of this, and why it’s important to the practice. Kathleen: Right, I agree. So the feedback that CMS is getting from this is they’re gonna compare your performance with other peers in your same specialty. And really, the overall goal here is to make changes to payment structures and implement new rules. So, you know, a lot of times you put things on the back burner but, you know, we’re gonna get into later on why really it’s not a good time to do that. We talked about PQRS and what it is and really what it stands for. So, you know, what’s the problem? Why is PQRS a problem? Well, PQRS is a problem because what’s gonna happen is that right now for 2013, the requirements have actually changed. For 2013, you had to report on 20% of your eligible patients within the year and only report on three measures, okay? If you didn’t do that, you’re gonna be penalized by Medicare in 2015 and that’s based on your Medicare allowable. By the way, nobody knows on this call what the Medicare allowable is going to be in 2015. I wish I had a crystal ball for you but I don’t. So for 2014, the rules have changed. So now we go from 20% of your eligible patients now having to report on 50% of your eligible patients. I know most of you out there are going, “Well, what’s an eligible patient? Is that all my Medicare patients?” And we’re gonna get into that, and, you know, nine reporting measures. “Well, what if I don’t have nine reporting measures? What if I only have three? Will I still be penalized?” And we’re gonna get into that as well. But what I’m trying to show here is that you’re trying to juggle a lot of things right now and things are now changing in the industry. Fifty percent of your eligible patients, nine reporting measures, if you don’t report for PQRS in 2014, you’ll have a 2% reduction on your Medicare allowables for 2016, ’17, ’18, ’19, ’20, and so on until they stop. So just remember that. It’s 2016 onwards, not just 2016. So that’s why this is such a huge problem, because this is not going to affect one year. We kinda then have to talk to why is the problem important? The problem is hugely important for a specific reason. Anytime CMS implements something, and they want you to be part of something because they want to make an effect in your industry. So I represented this by a fish bowl effect. On the left-hand side, we have a couple of fish just swimming around,
Chiropractic Office Workflow Improves Your Practice
Workflow will help your Practice grow! Workflow is the wave of the future. When it comes to managing your practice, it’s often difficult to make informed, timely decisions. That’s because practice owners are unaware of the difficulties in managing a growing practice. Memory management isn’t the solution because it’s impossible to remember everything and most details get lost in reports full of numbers. Learn about workflow and how it can help your practice grow.
Fast and Compliant Notes for Your Practice
Please view this free webinar about having compliant documentation for Chiropractic Offices, as well as other medical specialties. Your documentation is done with clicks, not written narratives. Many of our clients get so fast at the clicks that they can complete their SOAP note in 15