In the 2019 Physician Fee Schedule Final Rule (83 FR 59847), the Centers for Medicare & Medicaid Services (CMS) established a policy that provides for the suppression of measures in certain circumstances. Starting with the 2019 performance period, for measures significantly impacted by clinical guideline changes or other changes where the CMS believes that adherence to … [Read more...] about 2019 Performance Period Suppressed MIPS Quality Measures
Increasing profits
MIPS data submission deadline extended to April 30
The 2019 Merit-based Incentive Payment System (MIPS) data submission deadline has been extended by 30 days to April 30, 2020. In general, if you have already submitted MIPS data or if you submit MIPS data by April 30, 2020, you will be scored and receive a MIPS payment adjustment based on the data you submit. Many MIPS eligible clinicians have performed very well in the MIPS … [Read more...] about MIPS data submission deadline extended to April 30
CMS to provide accelerated and advanced payments during patient surge
In response to the COVID-19 pandemic, CMS will provide accelerated payments to requesting providers and advance payments to requesting suppliers, including physicians and non-physician practitioners, who submit a request to the appropriate Medicare Administrative Contractor (MAC) and meet the criteria: CMS intends to provide assistance first to those providers and suppliers … [Read more...] about CMS to provide accelerated and advanced payments during patient surge
MIPS 2020 payment adjustments in effect based on 2018 performance
In July 2019, each Merit-based Incentive Payment System (MIPS) eligible clinician received a 2018 MIPS Final Score and associated payment adjustment factor(s) as part of their 2018 MIPS performance feedback, available on the Quality Payment Program website. 2020 MIPS payment adjustments, based on each MIPS eligible clinician’s 2018 MIPS final score, will now be applied to … [Read more...] about MIPS 2020 payment adjustments in effect based on 2018 performance
5 ways to break down bureaucracies to get payer contracts
By Steve Selbst bio It is important to remember that payers are large companies, with protocols, policies and business practices. As with any large company, there are bureaucracies, and they are necessary to maintain the order and success of these organizations. Therefore, the first tip is to understand that to get contracted you need to identify the right department and … [Read more...] about 5 ways to break down bureaucracies to get payer contracts
How to assess the overall health of your medical practice
By Nick Hernandez bio How do you know that your overall business is healthy? How do you know that the business processes you perform are working properly? Now, how would others in your practice know? Metrics are important for a number of reasons. For starters, if you don't know how well you are doing, how do you know what to keep doing and what to change? Words without … [Read more...] about How to assess the overall health of your medical practice
Improving your revenue cycle efficiency
Modern medical practices are experiencing immense pressures as a result of increased regulatory scrutiny, changing reimbursement mechanisms, and a shift toward more patient-focused care. Revenue cycle management is particularly challenging, given all the complex rules, the number of people involved, and the tools and systems used to capture and process the information, … [Read more...] about Improving your revenue cycle efficiency
Getting that new patient info into EHR before appointment
Here are some reader tips for getting new patient information into the electronic health records prior to an appointment. They come from Tina Wheeler, Practice Manager for General and Laparoscopic Surgical Associates in Maryville, Il. This busy multi-physician general surgery office has four physicians and one nurse practitioner, with patients scheduled among these five … [Read more...] about Getting that new patient info into EHR before appointment
CMS releases 2020 Proposed Rule for the Quality Payment Program
The Centers for Medicare & Medicaid Services (CMS) has released its proposed policies for the 2020 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). Key proposals for 2020 performance year of the Quality Payment Program include: Increasing the performance threshold from 30 points to … [Read more...] about CMS releases 2020 Proposed Rule for the Quality Payment Program
MIPS bonuses are easy to earn—IF you can get into the program
The Centres for Medicare and Medicaid Services (CMS) has announced the results of 2018, Year 2 under the Merit-based Incentive Payment System (MIPS). Bottom line: The total number of clinicians participating declined from 1.06 million to 916,058. However, the success rate of participants was higher with 97.6% earning an upward payment adjustment on their Medicare Part B claims … [Read more...] about MIPS bonuses are easy to earn—IF you can get into the program