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What Future Holds for Quality Payment Programs?

CMS (Centers for Medicare and Medicaid Services) is the ultimate authority that serves as a guiding light for clinicians in America. QPP (Quality Payment Program) is one of its programs that is meant to streamline the clinicians’ financial matters through various sub-programs, such as MIPS reporting, APM reporting, ACO reporting , etc. With time, these programs have undergone some changes in terms of improving their outcomes or reducing the administrative load. For instance, MIPS reporting that was in the year of its inception is different now. The same goes for every other program. Now, CMS aims to transform other QPP programs as well to adopt the changing healthcare industry. Clinicians have many other things on their plate, they also must cater to the administrative load. So, just to be prepared in this regard, here is a brief description of what to expect in the future in QPP. The Introduction of MVPs MIPS reporting is going to shift to a new reporting framework, namely MVPs (MIPS
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Bird’s-Eye View of Final Medicare Physician Fee Schedule 2021

We are dealing with a public health emergency, and CMS has proactively come forward to facilitate clinicians in Quality Payment Program (QPP). This year, the final rule for QPP MIPS data submission required some flexibility to accommodate the pressure. CMS recently released the final 2021 Medicare Physician Fee Schedule. P3Care, being a MIPS Qualified Registry , keeps an eye on updates. In this blog post, we have mentioned all the necessary information that MIPS eligible clinicians need to know for QPP MIPS 2021 data submission.  QPP MIPS 2021 Reporting Highlights  The Final Rule for the Medicare Physician Fee Schedule includes several changes as follows. These changes were finalized, keeping in check the corona situation. Implementation of MIPS Value Pathways  In normal conditions, MIPS Value Pathways (MVPs) were expected to come into effect from 2021. However, post-pandemic, its implementation has been delayed until 2022. Moreover, CMS is also encouraging all stakeholders i
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9 Reasons Why Your Practice Needs Medical Record Audit

No matter how much of a tedious task it may seem, the audit of medical records is in the best interests of the practice. It can save physicians and medical billing services from clinical documentation disasters. An audit prevents the billing system from inconsistencies and helps put measures in place to safeguard the system from malicious viruses and unauthorized access. Many errors can be avoided only via a medical record audit. The sustainability of a successful medical billing and coding system thus relies heavily on the accuracy of medical records, and medical record audit helps to maintain that. Why Should Medical Billing Services Audit Records At Least Once a Year? A medical billing company ensures the confidentiality and accuracy of the medical information. If a practice is not performing well financially, there might be a problem in the billing system or medical records. Professional billing auditing companies like P3Care never compromise on risk analysis. Therefore, o
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Telehealth Billing on the Rise: Will It Survive After the Pandemic

If one good thing came out of this pandemic, it is the rise of Telehealth services in primary care. Medical billing services had to modify their billing structure to include Telehealth billing services to their manual. As a result, they have to work for their client payments, in which their expertise is tested the most. The boost in the Telehealth sector is not just an estimation but based on a data a report issued by HHS (The US Department of Health and Human Services). Digging deeper into the analysis of this report shows us that Telehealth visits per week increased from 2,000 to 1.28 million. Moreover, Medicare spending in this sector went up from 0.1% to 43.5% from February to April 2020. Meanwhile, the in-person visits dropped significantly with a rise in mid-April to May 2020. Since life is going back to what it was before the pandemic, we see a rise in in-person numbers and they are almost leveling up with the Telehealth visits.  However, the rate is still lower tha
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The Impact of Technology on Medical Billing and Coding

Medical billing and coding have undergone various changes. At first, the payment transaction methods were not clear. Then from the late eighties to until a decade ago, billers and coders had to write down every single detail manually on papers. The information collected was cipher into the designated codes or electronic codes to be stored in the hospital’s database. You can assume that the process of getting claims was surely not a cup of tea. It was lengthy, and most of the time, human errors were a big problem in creating clean claims. Since technology has been a great invention and is making waves in the medical billing industry like other fields. Now professional outsourcing billing companies relay on encoders to mitigate human errors and to increase the precision of the claims. The process is more streamlined than ever and aligned with the companies’ objectives. But relying simply on encoders can also seriously damage your claim processing. Why Professional Medical Coders a
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Nature Sweetens the Bitter Taste of Isolation

With restrictions applied nationwide and people under obligation to stay at home, our mental health is at risk. One way or the other, we must have a plan in place on how to get through the days in quarantine. According to the Mental Health Association, 1 in 5 people will experience a mental health condition. This year the theme is, Tools 2 Thrive (#tools2thrive) that every person can use to help those who are suffering. As a result of this recent onslaught of COVID-19 across the United States, this figure of 1 in 5 could only worsen. Whether it is by choice or fate, the state of isolation can be a big stressor and can easily develop into mental health symptoms. Let’s look at a few ways to manage ourselves at such times. Nature is therapeutic Lisa M. Carlson , the President of the American Public Health Association, says and I am paraphrasing it: It is in nature that we must look for relief, peace, and contentment. That’s true in every sense of the manner. She calls natura
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Exploring the Basics of Medicare MIPS 2020 in Healthcare

Whether it is about MIPS 2019 or Medicare MIPS 2020 reporting , Qualified Registry is one of the most authentic ways to do it. It is one of the collection types recognized by CMS to submit on behalf of the providers. Submissions further split into three types: either you can report it as an individual clinician, as a group, or as a virtual group. Whatever you choose to be, remember, it is your career and incentives on the line. CMS Released New Data on Medicare MIPS 2020 If you have been a late bloomer in the previous installment of the MIPS program (MIPS 2019) and couldn’t submit data on time, there is still time to do that until March 31, 2020, the deadline. As far as Medicare MIPS 2020 is concerned, it has just started so you have plenty of time as a clinician to report it. Nevertheless, we advise you to report it at the earliest to remove the chances of penalties later on. Another name of Medicare Access and Chip Reauthorization Act (MACRA) is compliance. As a practice
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