Tuesday, September 2, 2014

The Incentive Programs




The Incentive Programs

 

Meaningful Use (MU)

The Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs will provide incentive payments to eligible professionals and eligible hospitals as they demonstrate adoption, implementation, upgrading, or meaningful use of certified EHR technology. These incentive programs are designed to support providers in this period of Health IT transition and instill the use of EHRs in meaningful ways to help our nation to improve the quality, safety, and efficiency of patient health care. 

HEDIS 

Most of the profiled purchasers and insurers link incentives to some measures that are included in, or derived from, the Health Plan Employer Data and Information Set (HEDIS)--a group of standardized measures designed to evaluate health plan

performance. However, a number of profiles also highlight unique performance

measures that were developed by progressive organizations. In light of the Institute of Medicine’s recent reports on the extensive and negative impact of medical errors, some purchasers and insurers have created incentives designed to improve patient safety and reduce medication errors. 

 

PQRS
 

Eligible professionals who satisfactorily report quality-measures data for services furnished during a PQRS reporting period are eligible to earn an incentive payment equal to a percentage of the eligible professional's estimated total allowed charges for covered Medicare Part B Physician Fee Schedule (PFS) services provided during the reporting period.
 

Incentive payments for each program year are issued separately as a single consolidated incentive payment in the following year. Incentive payments are issued to the first valid group location listed under the TIN; or, for solo practitioners, to the first valid practice location listed under the TIN. 

The Medicare claims-processing contractors (Carrier or A/B MAC) will make the payment electronically or via check, based on how the TIN normally receives payment for Medicare Part B PFS covered professional services furnished to Medicare beneficiaries. If a TIN submits claims to multiple Carriers or A/B MACs, each contractor may be responsible for a proportion of the TIN incentive payment equivalent to the proportion of Medicare Part B PFS claims the contractor processed during the applicable reporting period.  

Understanding and billing for the different quality Measures requires time and effort. The physician  and staff must be familiar with all of the regulation in order to qualify each Measure. 

AccuChecker Online is the solution for qualifying  the various Measures:

AccuChecker introduces the HEDIS Module,  the PQRS Module and the ICD-10 Module . Please take a glance at:  www.accuchecker.com
 

For details , your Free Trial or a Webinar call 305-227-2383  or  1-877-938-9311 .
 

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