The new MIPS Eligible Measure Applicability process gives providers who were unable to submit the required number of quality measures a chance to still earn the maximum score for that reporting category. READ MORE
Back in July, Medicare Administrative Contractor WPS-GHA randomly selected 100 Indiana and Michigan claims which contained CPT code 99285 for prepayment review. Shockingly, of these 100 services, only three (3.06 percent) were allowed as billed, and the remaining 97 (96.94 percent) were denied. What can we learn from these results? READ MORE
The Medicare PQRS and Value Modifier programs may feel like a distant memory for providers who are now in the thick of trying to figure out the new MACRA Quality Payment Program guidelines. Unfortunately, some providers may still experience the negative effects of these sunsetting programs as the Centers for Medicare and Medicaid Services releases the results of the final reporting year and how they will affect provider payments. READ MORE
According to an MGMA poll from earlier this year, only about 50 percent of respondents said they compare their actual reimbursement to payer contracts at least quarterly. The other 50 percent were unsure how often they do it or don’t do it at all. So what’s the big deal? Why is important to regularly compare the payments you receive to the contracted payment rates you’ve negotiated? Here are 7 reasons you should establish a plan for your own practice and begin monitoring your payer payments today. READ MORE
The ASA recently submitted comments to CMS related to the 2018 Quality Payment Program Proposed Rule. The goal of their 28-page letter, according to a prepared statement by the ASA, is to ensure “physician anesthesiologists have ample opportunities to meaningfully participate and succeed in either the Merit-based Incentive Payments System or Advanced Alternative Payment Models pathways under the QPP.” READ MORE
Medicare will soon begin replacing beneficiaries’ social-security-based Health Insurance Claim Number with new randomly-assigned Medicare Beneficiary Identifiers (MBI) to help protect against fraud and identity theft. Congress mandated the change through the Medicare Access and CHIP Reauthorization Act (MACRA) with an April 2019 deadline. READ MORE
