The healthcare industry is on the move; the old conventional reimbursement patterns have evolved to incorporate quality-based healthcare. CMS with commercial payers collect quality data reported by providers, and once the results are out, physician’s ratings are available on the Physician Compare portal. This way, a progressive healthcare system possesses value-based clinicians with ratings.
CMS & NCQA are the two monitoring bodies to assess the performances of clinicians. Physicians are either in for a reward, penalty, or nothing at all, based on the quality of service they provide. Whatever the output is, it directly affects their next Medicare reimbursement status. P3, as a MIPS consulting service, works consistently on rewards and bonuses for their clients.
PQRS, MIPS, MACRA, HEDIS, PCMH, PCSP, GRIP, Meaningful Use (MU)/Promoting Interoperability (PI), Value-based Modifier (VBM), and pay-for-performance models are all forms of quality-based healthcare initiatives. These programs assist healthcare providers with quality care all the way through. In general, they are here to speed up the wellness journey for patients and to decrease healthcare expenses.
By the end of the Sustainable Growth Rate (SGR) program, Medicare gets rid of the costly volume-based approach and gives way to a fairer value-based system. In the future and even at present, a quality healthcare system is inevitable through these performance measuring programs – MACRA & MIPS, and Advanced APMs.
CMS has its focus on tracking provider performance, while NCQA has all eyes on the complex chain of quality programs. The data gathering, reporting, and evaluating processes are all in place to impact future reimbursements.
P3 is primarily a revenue cycle management company with its focus on medical billing and MIPS consultancy. Provider billing services is where we aim to assist our clients the most. While some of them are eligible for MIPS reporting, even if they are not, CMS encourages them to report through the opt-in option.
The financial process and to maintain and retain collections are both complex and arduous. Therefore, we have to put in hours and hours of work to get you paid on time and in full. As a medical billing service, our coding team carries the most current knowledge of CPT and ICD-19 coding systems. Moreover, we are here since 2015 with more than 500 satisfied clients and counting.