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Medical billing and coding, healthcare industry, medical billing companies, healthcare organization, revenue cycle management, healthcare professionals, HIPAA Compliant, medical billing outsourcing services, medical billing services, medical practice

How Accuracy of Medical Claims Could Save Your Revenue?

Medical billing and coding is an important step in the physician’s payment model. Depending on the compiled claims by the medical billing outsourcing services, insurance companies decide if the rendered services are valid and if physicians should be reimbursed. Therefore, the accuracy of the claims and medical billing services holds a crucial place in the healthcare industry.

Medical billing and coding, healthcare industry, medical billing companies, healthcare organization, revenue cycle management, healthcare professionals, HIPAA Compliant, medical billing outsourcing services, medical billing services, medical practice

Why do Experts Stress on Accuracy of Claims?

If physicians want to get reimbursed on time, the accuracy of the claims should be maintained. The wrong documentation or manipulation of data results in denied claims, even when the physician has provided the service to the patient.

Another issue is the under coding when physicians are not paid as much as the service cost because of coding errors.  Over coding can also dent the reputation of your healthcare organization. You can be charged with fraud and can bear financial and legal complications.

The survival of the medical practice can become difficult if medical billing companies don’t pay attention to the accuracy, resulting in revenue loss.

It’s also about the reputation of the medical billing companies, the high claim’s acceptance rate they have, the more revenue they generate, and the smother revenue cycle management become.

Medical billing and coding, healthcare industry, medical billing companies, healthcare organization, revenue cycle management, healthcare professionals, HIPAA Compliant, medical billing outsourcing services, medical billing services, medical practice

Is Medical Billing and Coding Complex?

Medical billing services are a serious profession. The sensitivity of this field can be analyzed by its impact on healthcare professionals. There are several code sets and monitoring authorities, from which billers and coders can take guidance. Anyone, who is responsible for creating claims, must know about the exact diagnostic procedures, surgeries, documentation of symptoms, age, gender, pre-existing conditions, and all. Not just the claims must be accurate but also the HIPAA-compliant to ensure confidentiality of the information.

Staying up to date with the latest knowledge and creating claims accordingly is the skill and handling bulk of claims at the same time is tricky. It is also a fact that leaving medical billing and coding responsibilities to the in house staff can cause financial problems.

So, What Option is Left.

We suggest going for medical billing services is the best option for a seamless revenue cycle. They have a dedicated staff to handle all the information and tasks, which certainly, can’t be managed alongside other tasks as treating patients.

P3 Healthcare Solutions is a professional medical billing service that has years of experience in creating claims and is helping hundreds of physicians in maximizing their revenue and sharing their administrative burden.

Visit our website for further details – https://www.p3care.com/

QPP MIPS, MIPS Quality measures, MIPS reporting services, healthcare industry

How Can Physicians Increase Patient Referrals?

Survival in the healthcare industry is getting tough day by day. The cost factor to provide value-based healthcare services is doing well in patients’ favor, but it’s also been a burden for physicians. While MIPS reporting services, MIPS Quality Measures are the parameters to show progress in terms of interoperability, cost, quality, and improvement activities.

Other than making efforts to earn incentives and bonuses and to remain protected from penalties, MIPS has been a great help. But, first physicians have to meet the criteria of checking 200 patients and bill more than $90,000 for Part B covered services.

Why Referrals are Important?

Referrals are an excellent way to keep up with the high number of patients. Word of mouth from fellow physicians and patients also helps to maintain goodwill in the industry.

It helps to grow the practice and improves the worth of your services rapidly.

How to Increase Referrals for your Practice?

Here are several suggestions upon which medical practitioners can thrive and get referrals without any problem.

  1. Connect with Fellow Physicians

Find those physicians in the industry with which you can build a give and take relationship.

For Instance, if you can refer a patient for any service to another physician, he should be able to do the same for you for your area of expertise.

  1. Increase Patient’s Engagement Level

Make processes easy and less hectic for patients. Such as a simple or automated way of patient scheduling system automatically improves patients’ engagement.

Another way is to send follow up messages to remind patients about their appointments.

These tactics can help to get referrals from patients.

  1. Have a Friendly Behavior at Work

When someone treats you with kindness, it leaves a long-lasting impact on you. The same rule works for organic referrals. If a physician treats his patients with a smile, listens to them, and take time to make things easy for them, he is more likely to get referrals.

  1. Be Kind to the Staff Working for You

Nurses, physician assistants (PAs) and others spend a major deal of effort and time for the well-being of patients.

Spend time with them, and make informal conversational sessions to release work stress. This way, your behavior, and kindness will not only improve your performance but also make an ideal working environment.

Another way is to get insight into your staff’s relationships with others in the healthcare industry to get benefit in your favor. Physicians can definitely deduce better results from this strategy.

  1. Embrace Technological Innovations

Adopting technology gives points for Improvement Activities (IA) in QPP MIPS. This way you get the reputation of a progressive medical practice and achieve higher MIPS points for incentives.

Medical practitioners can use the following things for starters:

  • Make your own app if possible
  • Make a user-friendly website for your services
  • Make the appointment process easy and automated
  • Use technology to offer support to employees and patients alike
  1. Be Informative & Unique with your Website

The website is the first portal to reach patients. Patients search online about what services they want and what doctor they need.

If you have all the information on your website, it’s easy to get referrals from others against your user-friendliness.

Given above are just a few ideas to improve physicians’ worth in the industry and getting referrals. More referrals mean more patients and ultimately reimbursements and incentives to straighten up revenue cycle management.

So, get started now.

One Day in the Life of a Medical Biller

Working in a medical billing company is not at all easy. Medical billing service providers go through a roller coaster of emotions every day. Gathering bulk of data from each clinician and carefully creating medical claims requires lots of effort.

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Let’s take you through the journey of how we manage to do it all, have a look!

When medical practices hire P3 Healthcare Solutions for a complete medical billing solution, we make sure to grasp on each detail that they offer to maximize revenue as per the demands.

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Medical billing and coding agents don’t really have much time to spend on other activities.  Whenever they’re spearing some moments with colleagues, an alarm clock inside their heads gets them back to work.

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One thing is certain; medical billers and coders are so used to tough times that nothing surprises them anymore. Not even denied medical claims.

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Insurance companies have strict rules; meeting their standards is almost like climbing up the K2 Mountain.

You guys can’t even imagine the feeling when medical billing services meet up their target and submit medical claims to the payers.

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The billers and coders usually go through a session of internal crying, upon receiving the news of the denied medical claim.

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After the tiring work hours, when we listen to the good news that insurance companies have agreed to pay the full reimbursement.

We go through a phase of shock, as getting money from a private payer is certainly not a piece of cake.

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And, then, we feel like clapping and dancing to our favorite beats.

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Insurance companies when to pay the required amount to clinicians, they, upon receiving the money become extremely excited.

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As a professional medical billing company, P3Care also get satisfaction by making our clients satisfied.

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Jokes aside, medical billing services work tirelessly; and, we find our happiness in serving the healthcare industry by sharing the burden of physicians.

5 Things Every Medical Billing Company in Ontario, CA Needs to Do!

If you own a medical practice or work in a hospital, you might have hired a medical billing company for claims submission. Whether you are a reliable medical billing company in Ontario, CA or not, the discussion today is important in the general sense.

If the respective medical billing service is an established one, there’s a 100% chance that it would have overcome all the loopholes in its medical billing process. If not, you should be a little careful while hiring medical billing services.

It is observed that up to 20% of medical claims are denied due to poor medical billing practices. As a medical billing company, you surely don’t want to have a bad reputation in the healthcare industry. So, given below are a few tips that you might want to follow. It will help you work better in favor of clinicians.

  1. Focus on Training Medical Billing Staff

If your medical billing agency recruits medical billers and coders, who have little or no experience in the respective field. You should immediately do something to train your staff because it might be causing major revenue loss for physicians.

Without proper knowledge, medical coders are unable to choose correct codes for the diagnosis. It is possible that they might be using the wrong modifiers for treatments.

Medical billing services should properly train employees as per the CMS guidelines to create and submit medical claims. So, there remains no chance of error.

  1. Tighten Up Your Follow –Up Services

Medical billing services need to interact with patients and physicians simultaneously while creating medical claims. It is a lot of work. Reporting accurate diagnostic and surgical procedures along with double-checking them takes a lot of time. Moreover, they also get faxes and emails every day in bulks.

When there is so much to do, things can pile up. However, despite a busy schedule, it is compulsory to keep a check on the submitted medical claims. Know about the claims’ status that either they are in process or have been denied. It has a crucial impact on revenue cycle management. Also, the follow-up services are time-specific, meaning, you can resubmit denied claims within a specified time. Otherwise, they get lost in the piles of papers.

Thus, professional medical billing companies never look down on the follow-up services.

  1. Keep Check on the Accounts Receivable (AR)

Some of you may not consider this point significant. But, it indeed plays an important part in the revenue generation.

Patients and even insurance companies generally don’t keep a check on the payments. However, medical billing companies should verify if a bill is fully paid or not. The unpaid reimbursements can take your revenue journey down.

If a bill is unpaid, you can always go for follow up services until accounts receivable are paid.

  1. The Filing Time Plays an Important Role in Revenue Generation

There’s a time limit for submitting claims to insurance companies. If a medical billing practice exceeds that time period, the claim will not add up in the revenue.

Even, you submit a claim within the time limit, there’s a chance that it might be rejected. Then, why take risk submitting it after time.

  1. Improve the Denial Management System

The percentage of denied medical claims is rising day by day due to strict rules of payers and governmental authorities.

Therefore, the medical billing and coding staff should be up-to-date with the latest news and criteria. Instead of ranting over denied claims, medical billing services should rectify errors and resubmit claims within time. An even better option is that the medical billing and coding process should be so transparent and precise to crash the chances of denied claims.

An experienced medical billing company straightens its billing process to maximize physicians’ revenue. P3 Healthcare Solutions is such a company that ensures high-quality medical billing for its clients.

Tell us if you think, above-mentioned tips can help a medical billing company generate more revenue at

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Attention! Medical Billing Companies are Charging More than Usual!

The Institute of Center for American Progress states that clinicians and insurance companies spend about $496 billion in the medical billing process. Either it is in the form of insurance or the cost incurred while hiring medical billing companies to create bills.

However, the alarming fact is that only about one-half of the huge money of administrative costs accounts for profitable billing. Moreover, medical practitioners and hospital staff also spend millions on providing value-driven healthcare.

Many times now, the debate is that the American healthcare industry is spending way too much on the administrative burden. Medical billing companies also suffer in this regard. They need to upgrade their systems to match the quality of administrative work.

What Should Be Done?

The high spending in healthcare with no particular outcomes has always been a concern. Thus, healthcare leaders have voiced the need for structural reforms in medical billing services.

Can We Expect to See Decrement in the Healthcare Expenditure?

As per the Recycle Intelligence, it is estimated by the governing authorities that if no major changes are done, healthcare expenditure will increase by 5.5% on annual basis with an increment of 19% in GDP.

America spends double the money on healthcare as compared to other nations, and still, it is not among the top healthcare systems of the world. Provided these facts, you can get an idea of where healthcare will be going in the coming future.

Reasons for High Expenditure on Medical Billing Companies

As mentioned above, the major reason to blame is the administrative cost. It has also influenced the physicians’ performance as they are forced to spend half of their precious time in counting numbers rather than doing their actual work. Thus, when they spend so much time on medical claims that may result in denial, how can they improve revenue cycle management?

In addition, the little revenue they generate is not solely spent on them. But, a significant portion has to be added in the accounts of medical billing services.

Different Billing Rates for Different Medical Procedures

Another reason that researchers found out is that different types of healthcare visits cost differently. For Instance, a study report of an academic health system highlights the following data set for medical billing.

  • The primary healthcare visit costs about $20.49.
  • Inpatient stay costs about $124.26.
  • Emergency department visit costs about $61.54.

Based on these facts and the revenue associated with each type of visit, emergency department visit accounts for the highest billing cost, up to 25.2% of revenue.

On the contrary, inpatient stay cost the lowest as associated with the patient’s stay in the hospital.

Time Spent on Billing Services is Huge

With administrative cost, comes increased time consumption while processing medical claims. On average, medical billing companies spend 13 minutes for primary care visits, 32 minutes for emergency department visits, and 73 minutes for a general inpatient stay.

The more time, medical billing services spend on analyzing medical claims, the more they charge physicians for their time.

Healthcare Industry Needs to Take Serious Actions!

Simple healthcare systems that have an easy reimbursement system can be a guiding light for the U.S healthcare industry.

Healthcare leaders propose that a single-payer healthcare system is a way forward towards the progressive route. However, only reducing the administrative burden will not generate favorable results for revenue cycle management.

Healthcare quality should be the focus along with setting forth reasonable rates for the medical procedures. Moreover, the centralized processing of medical claims can also reduce healthcare expenditure.

Comment if you believe these reforms will somehow show a positive influence on the US healthcare system, or, do you think the opposite?

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4 Reasons to Outsource Credentialing by a Medical Billing Company

Medical billing companies save revenue cycle management for clinicians. Without the assistance of medical billing services, we doubt the efficient running of medical practice.

The Healthcare industry is quite sensitive and responsible. Physicians are supposed to practice their skills for the ideal health status of individuals. Especially in the on-going approach of the value-based healthcare system, physicians need to modernize their treatment methods now more than ever. Hereby, medical billing companies create medical bills and handle the billing tasks to get the reimbursements. Consequently, physicians can pay attention to their actual work.

However, in addition to the billing process, a professional medical billing company also offers credentialing services for clinicians, which is a vital part of revenue generation.

What is Credentialing?

It is a process, in which hospitals, insurance companies, or healthcare authorities verify and legitimize the educational background, expertise, and qualification of a clinician. Generally, this process takes place before including a physician in the working network.

Why is Credentialing Important?

When physicians are credentialed, they get timely and rightful reimbursements from the insurance companies.

Medical credentialing is not an easy process and requires extensive focus from the start of the process to the end.

No Immature can look into clinicians’ past and derive professional outcomes. The credentialing process is legal and can result in penalties if done unethically. Hence, this responsibility should only be given to medical billing companies.

What are the Challenges that Occur During This Process?

Credentialing Takes Time

Medical billing companies and healthcare industry

Checking one’s background is a complex process. Therefore, it requires at least 60-90 days to fully credential a clinician.

Medical billing services when enlisting a physician for credentialing, are required to complete the whole process before he takes up a new patient. There is no room for error as the process involves the verification of sensitive fields such as employment history, education, medical training, licenses, and more.

Peers Don’t Cooperate

It is obvious that physicians are always tight on their schedule. Hence, there is little possibility that peers, who can give a vote of confidence for the physician will be able to respond to inquiries on time.

To avoid this delay in the credentialing process, physicians can inform their peers prior to the process. Moreover, they can also set a time to complete this task.

No Access to the Latest Information

Physicians need to have access to up-to-date information. However, medical practitioners are so busy in their lives that they remain oblivious of the latest information. For Example,

Clinicians working in the ambulatory surgical centers (ASCs) have to reevaluate their credentials after 1-3 years. When different clinicians have a different schedule for credentialing, it becomes hard for ASCs to manage all.

Thus, no access to the information at the right time creates issues for the credentialing service providers and the confirming authorities.

Inability to be Compliant with Value-Based Healthcare

Different states have different healthcare plans and so physicians are supposed to stay true to all the state exchange and federal healthcare plans.

Another challenge that a credentialing medical billing company faces is that physicians have to treat a reasonable number of patients to handle revenue cycle management. Moreover, medical practices should implement the right healthcare strategies. Otherwise, they’ll not be able to get reimbursements for the rendered services.

Considering the difficulty, medical practitioners choose to outsource for credentialing services. There is no way that unprofessional individuals should not take responsibility for this task. After all, physicians’ revenue generation is based upon it. Thus, only, a medical billing company as P3 Healthcare Solutions can outrun all the above-mentioned challenges for credentialing and insurance enrollment and offer an efficient solution.

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How Can MIPS Consulting Services Help Increase Your CPS?

MIPS has been an amazing initiative in the healthcare industry. This quality payment program instantly got attention from clinicians in terms of providing value-based services to patients. Therefore, the physicians’ participation rate has been outstanding since the very first year. This trend has also put pressure on the MIPS consulting services to use improved methods to better report clinical data.

Another reason for high participation is the fortification from the penalty that is imposed on non-participation or poor performance. This has to do a lot in changing physicians’ thinking to strive for being the top-scorer, especially, when there is so much to gain as incentives and bonuses.

Reporting MIPS quality measures with data completeness constraint requires accuracy and dedication from MIPS consulting services. The thing to consider is that healthcare organizations already have data and then consult MIPS qualified registries to report data.

Then, how can MIPS consulting services improve performance based on the present data? This question demands thorough analysis and this article gives insight into four MIPS score-increasing tactics.

  • Document Data for a Large Set of Quality Measures & Look for High Performers

This is the simplest way to ensure that the data you have is best for reporting MIPS quality measures. When healthcare organizations consult MIPS consulting services, most of them already know about the best-suited quality measures. However, there are some that at the start of the MIPS reporting period, run hundreds of tests to determine the most scoring MIPS quality measures.

The advantage of running this strategy besides the obvious one is to check if you can get extra points from the available data while submitting it to CMS. Moreover, the search for high-priority measures becomes easy for MIPS consulting services via this method.

Some professionally qualified registries or even healthcare organizations tend to chase a larger set of performance measures throughout the year. This way, they get the flexibility to report for the best performing measures at the end of the year.

  • Switch to Electronic Methods for Reporting

The end-to-end electronic reporting method is the best way to earn bonus points, and thus requires data submission through Certified Electronic Health Record Technology (CEHRT) to CMS. It automates the data submission process with efficient data extraction and measures calculation.

This method helps MIPS consulting agencies to earn additional points per measure or even increase 10% of the total MIPS score.

  • MIPS Consulting Services Should Report Free Text DataMIPS Consulting and quality measures

Qualified services should invest additional efforts in collecting free-text data. It surely involves the extra time and a bit of investment but can result in improving the MIPS scorecard.

Going through patients’ reviews and medical codes can help taking out important points. A dedicated team is required to abstract data for this purpose. Otherwise, outsourcing companies can also do this favor for MIPS consulting services.

  • Review the MIPS Score for Individual & Group Performance

Getting incentives and eligibility for the bonus pool gear up physicians’ performance and it is only possible when MIPS data is optimized. Before data submission, reporting services should check performance rates both as individuals and even as a group.

It is possible that clinicians get more points while submitting data as a group for treating a similar set of patients. It also helps to add low-performing physicians in the group that may be excluded from the MIPS race as individual healthcare providers.

Thus, physicians can earn a high score when MIPS consulting services uses a few simple tricks. Indeed, these tricks require efforts and but continuous monitoring of score throughout the year, provide opportunities to increase revenue cycle.

As a MIPS consulting service, would you try these tactics or have any other ideas for high MIPS score, share with us at https://www.linkedin.com/company/p3-healthcare-solutions

MIPS and MACRA, EHR technology, healthcare industry, healthcare provider, Healthcare clinical process, Medicare and Medicaid Services, value based healthcare

The Role Of Clinical Quality Measures For Physicians

Since the healthcare industry has taken serious measures to revamp healthcare services, the emphasis on incentive payment programs has increased. MIPS and MACRA, and more offer facilities to physicians that regular payment method can never provide.

Such incentive payment programs come with various quality measures against which clinical data is needed to report. The number of clinical quality measures is so large that it is difficult to manage them for each healthcare provider. Moreover, the requirements for each program be it Meaningful Use (MU), MIPS or others and the implementation of reporting criteria can be quite confusing.

The Center for Medicare and Medicaid Services (CMS) states Clinical Quality Measures (CQMs) for incentive payment programs. The result is not just to pay physicians but the value-based healthcare improvement efforts. These clinical quality measures also put their part in various government or private development projects.

Need of CQMs

Eligible physicians and hospitals submit data to CMS as in MIPS. In return, CMS estimates their performance and reward accordingly while checking that patients are getting the deserved attention from physicians. In addition, it works in favor of the healthcare industry to improve performance categories, falling short in terms of efficiency and quality.

What factors determine success in Clinical Quality Measures Submission?

As per the CMS website, it checks the following parameters to score CQMs.

  1. Use of available resources
  2. Compatibility to healthcare standards
  3. Healthcare outcomes
  4. Patient’s safety and welfare
  5. Coordination among physicians
  6. Patient’s engagement level
  7. Population & overall health standard
  8. Healthcare clinical processes

To maintain the accuracy and transparency in the healthcare system, ONC, Office of the National Coordinator for Health Information Technology (US Government Health and Human Services), monitors the use of EHR and other technologies.

The Development Process of Clinical Quality Measures (CQMs)

MIPS and MACRA, EHR technology, healthcare industry, healthcare provider, Healthcare clinical process, Medicare and Medicaid Services, value based healthcare

National Quality Forum

Many healthcare industry leaders and stakeholders take part in developing CQMs. However, measures standardized by the National Quality Forum (NQF) are considered as the top priority. Most of the incentive payment programs use their measures because their development process involves extensive research.

Another reason for adopting NQF quality measures is their work and objectives that match with that of CMS. Moreover, their initiative boosts the use of electronic healthcare records (EHRs).

Development Process via CMS

CMS also has its own measure development project known as The Measures Management system. This system is always in its evolution stage and sets values for business processes. The deduced measures also support MIPS and other incentive payment programs and provide an opportunity for their growth.

Real-Life Implementation of Quality Measures

Clinical quality measure reporting accounts for many uses, but its major reliance is on EHR technology usage or Meaningful Use. However, many healthcare providers deem Meaningful Use to be stressful and demanding. Moreover, not every quality measure is for everyone. Thus, there should be some flexibility in the reporting criteria.

CMS has gone to great lengths to overcome reporting issues and streamlined measures under seven categories.  When physicians are reimbursed and incentivize, it becomes obligatory for them to maintain their performance instead of giving quality as a onetime shot.

Clinical quality measures are also a great aspect of Physicians’ Quality Reporting System. Physicians are met with penalties when they don’t report according to the standards.

Thus, MIPS, MACRA, and other payment incentive programs can’t perform their actual functions without efficient marking of clinical quality measures. The key to success is the selection of accurate measures according to the practice and the value-based approach of practicing physicians towards patients.

For more information, visit https://www.linkedin.com/company/p3-healthcare-solutions

Highlighted Aspects Of Medicare Usage Of EHR Technology For Hospitals!

The healthcare industry emphasizes on value-based medical services to patients with the correct use of technology and innovation. The purpose is to empower physicians’ RCM and patients with the right to choose quality care services. MIPS is a great addition in this context. It allows physicians to take small steps towards a better healthcare system. However, along with MIPS, the Medicare EHR incentive program also shares the responsibility with the same approach.

Since many hospitals don’t use EHR technology until now. However, the healthcare industry will only progress forward in a secure environment when using the latest technologies. For encouraging physicians and boosting their RCM, The American Recovery and Reinvestment Act of 2009 (ARRA) initiated a program under Medicare. It was to facilitate eligible physicians to use the Certified Electronic Health Record (CEHR) technology meaningfully.

CMS named this program as Medicare Promoting Interoperability (PI) since last year. MIPS also contains this category featuring the benefits of this program, ensuring advancement in healthcare services with the appropriate use of EHRs. This measure appreciates interoperability efforts and applauses for allowing reasonable access of patients to information.

What if Clinicians don’t meet the Promoting Interoperability (PI) criteria!

Healthcare organizations that don’t illustrate the correct depiction of PI will not get payment adjustment for the respective year.
Healthcare, which participates in both incentive programs i.e; Medicare and Medicaid EHR programs can subject to payment adjustments only when it demonstrates the true value in its reporting.

Reporting Criteria for EHR Incentive Program

Prior to 2018, physicians demonstrated EHR use via either CMS Medicare EHR Incentive Programs Attestation System or the state’s attestation system. Now, QNet System confirms the EHR meaningful use and payment adjustments are calculated via a formula specified by the CMS.

What Expectations Should clinicians have for payment adjustments for 2019?

Eligible healthcare organizations, which are not meaningful EHR users, get payment adjustment as a reduction to the applicable percentage proportional to the Inpatient Prospective Program System (IPPS). Thus, it reduces the IPPS standardized amount of healthcare centers.

What are the hardship exceptions?

MIPS and the EHR meaningful uses

Eligible hospitals can avoid negative payment adjustments through hardship exceptions on day-to-day scenarios. Sometimes, CMS itself determines that eligible healthcare falls in an exceptional case.

To apply as an exception, clinicians or hospitals can get information on the official CMS website.

https://www.cms.gov/Regulations-and- Guidance/Legislation/EHRIncentivePrograms/PaymentAdj_Hardship.html

Given below are the categories for hardship exception cases.

1. New Eligible Healthcare Organizations

Healthcare organizations having new CMS Certification Numbers (CCNs) and insufficient time to submit data can get relaxation for 1 year.

2. Infrastructure Liabilities

Eligible hospitals having no Internet access in their operating area or with insufficient resources to meet the threshold of EHR meaningful use.

3. Unexpected Circumstances

In the case of natural disasters or unforeseen conditions.

4. Vendor Related Issues

Hospitals can apply for this category when they encounter EHR vendor issues to obtain a certification or due to related delays.

What will physicians get in return for their efforts?

  • The foremost purpose is to avoid negative Medicare payment adjustment, and thus revenue cycle management becomes efficient, supporting all the financial matters.
  • The healthcare system improves, and the transparency travels across the board from a higher level to a lower level.

Thus, EHR technology is not just about technology incorporation but a way to fill gaps between patient and physician. Moreover, the advancement in its context helps in successfully submitting clinical data for MIPS as well. Consequently, the healthcare industry flourishes.

Consult the official CMS website for further information https://www.cms.gov EHRIncentivePrograms

Or, visit our LinkedIn page

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Key Points:

  • EHR incentive program
  • The result when not submit data for this program
  • Payment adjustment criteria
  • Hardship exceptional cases
  • Advantages

P3CARE Offers What Physicians Exactly Want!

The Healthcare industry is evolving at a fast pace. This revolution has led all stakeholders to adapt to unconventional ways of attending patients. Moreover, the MIPS payment model has turned the quality of medical services upside down. It serves to comprehend the importance of valuable health services along with the financial needs of physicians.

P3Care isn’t a new name and been known as a legendary MIPS qualified registry in the competitive industry. Their focus is entirely on accurately reporting MIPS to support and uplift revenue cycle management (RCM) for medical practitioners. The reporting pattern is so precise that saves physicians from penalties and makes them eligible for incentives and bonuses.

Getting a star rating from a physician compare portal is not any problem for their professionals. The Centers for Medicare and Medicaid (CMS) and the National Committee for Quality Assurance (NCQA) monitor and ensure the quality of medical service and reward accordingly. P3Care is well aware of their standards and help physicians to get a prominent position in the healthcare industry.MIPS qualified registry

How P3Care’s MIPS Reporting Services Credit to a Physician’s Success?

The Efficient MIPS Consulting Service

MIPS has been operational for two years now. It has changed quite a lot in terms of higher standards and reporting requirements. The threshold for eligibility and penalty prevention is also increased as compared to last year.

The reporting experts at P3Care are experienced and trained enough to recognize the tricks and tactics that can benefit in higher MIPS score. Preventing physicians from penalties is not their goal. Rather, they aim for incentives to increase revenue and get appreciation in the respective industry.

What Makes P3Care Different from Others?

When you have the goal of helping physicians and hospital systems to accomplish their objectives in the first place, your efforts should match respectively. P3Care no doubt possesses this quality.

It doesn’t matter if your practice is a small-scale or a well-established one, maintaining the balance of eligibility for higher points without putting too much pressure on practice to spend more, is an art. And, P3Care is a pro in this field.

  • The credentialing specialists at P3care ensure your legitimacy and enable you to get the rightful fame in the healthcare industry.
  • They spend quality time understanding the services you offer to patients and suggest improvement methods in your system.
  • From a budget point of view, they are very flexible and report clinical data as per your expertise.
  • Moreover, only by understanding your medical expertise, they plan and select the right MIPS quality measures to confirm that you get more MIPS points.

HIPAA – Compliant Medical Billing Services

P3Care is a renowned qualified registry for the last two years. However, it is also known as a leading medical billing service in the USA. Gone are the times when creating medical bills was that simple. Ensuring the patient’s and physician’s privacy is equally important. Therefore, HIPAA – compliant medical billing services serve the purpose.
Using the latest technologies such as; EHR technology to target Medicaid Meaningful Use (MU) and protecting the private information is their expertise. Patients feel secure and trust healthcare providers for the confidentiality of their data.

They have separate dedicated teams for creating medical claims and submitting to payers and reporting clinical data to CMS, according to the requirements.

P3Care – Your One Stop Place for Reporting Services

Many happy and satisfied clients testify P3Care performance. According to the founder of SunCoast, RHIO, Lou Galterio stated in a telephonic interview for Clutch. Co that his experience with P3Care has been immensely amazing! Their team is dedicated and leaves less room for error.

If your practice is unable to improve revenue cycle management and can’t find break-through for a penalty-less spot, consult P3Care services and experience what it likes to be in a prominent position in the healthcare system.

To talk to their H I.T consultant, visit their website https://www.p3care.com or call right away 1-844-557-3227

News

QPP MIPS 2020, MIPS 2020, MIPS Qualified Registries, MIPS and Macra, CMS announces, Medicare Quality Reporting, coronavirus pandemic, healthcare industry

CMS announces QPP MIPS reporting Relaxations for 2020

The last few months have been tough for the healthcare industry. All stakeholders were trying desperately to assist each other and save resources for COVID-19 response.  Of course, meanwhile, CMS also took necessary measures to unburden some of the clinicians’ load.

Where physicians have already burned out with COVID -19 cases, the administrative burden of QPP MIPS 2020 was additional pressure. The dynamics have changed. The contact points that were easily accessible before are now operational via online mediums.

Thus, eligible clinicians and MIPS Qualified Registries can take benefit from it and serve effortlessly to the patients.

At first, CMS requested clinicians to impede elective medical procedures. In simple terms, it means to delay diagnostic procedures or treatments that don’t qualify for emergency conditions.

The process of offering flexibilities continues for the QPP MIPS.

Relaxations for the QPP MIPS 2020

CMS states that the eligible clinicians who are significantly impacted by the public health emergency can apply for Extreme and Uncontrollable Circumstances to reweight any of the four or all MIPS performance categories.

However, they are required to submit a solid explanation for the impact on their medical practice.

A COVID-19 clinical Improvement Activity under MIPS is also introduced by the CMS.  Eligible clinicians can obtain outcomes via:

  • Participating in a COVID-19 clinical trial Improvement Activity and submit data into a data platform
  • Participating in the healthcare of COVID-19 infectees and submit patients’ data to Clinical Data Registry for research

As physicians are busy battling against coronavirus pandemic, CMS has decided to not use data reflecting from January 1st to June 30th, 2020 for the Medicare Quality Reporting and value-based purchased programs. These measures are taken to give advantage to eligible physicians to some extent as to minimize the administrative burden incurred during data collection and management. A lot of time and investment can be saved, henceforth.

Medical Billing Services, Medical Billing Companies, Healthcare industry, Medical Billing Company, Medicare and Medicaid Services, QPPMIPS

Guide to the Latest Medical Billing Codes for COVID-19 Test

The constant threat of coronavirus has led the panel of AMA – The American Medical Association to introduce CPT (Current Procedural Terminology) codes for medical billing services.

As the number of infected cases in the USA increased, the need for a separate code for COVID-19 testing emerged. The president of AMA, Patrice A. Harris, MD, MA, announced a unique code to report for laboratory testing of the coronavirus. This information was released on March 13, 2020, in order to translate the advantages of tracking, allocating, and optimizing resources.

What’s New for Medical Billing Services Regarding Corona Test Coding?

The coronavirus code belongs to a new category I of CPT codes.  The details are as follows.

  1. 87635 infectious agent detection by nucleic acid (DNA or RNA)
  2. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), for the examination technique

The codes are now available to use to report on behalf of physicians by the medical billing companies. This code also has short and medium descriptors, which can be accessed on the official AMA website – https://www.ama-assn.org/practice-management/cpt/cpt-releases-new-coronavirus-covid-19-code-description-testing

Coronavirus around the Globe

The situation of the novel coronavirus is serious. President Trump has declared a national emergency in the USA, and the only way to stay safe is by maintaining the social distance.

The Healthcare industry, in almost every country, is under pressure to combat the seriousness of coronavirus pandemic. The number one step for managing this catastrophe is by dealing with hundreds and even thousands of diagnostics procedures, and this code will help deal with the billing matters.

Rick A. Bright, Ph.D., director of Biomedical Advanced Research and Development Authority (BARDA) at HHS stressed the need of increasing the capacity of testing kits to identify and separate infected individuals as early as possible.

Medical Billing Services, Medical Billing Companies, Healthcare industry, Medical Billing Company, Medicare and Medicaid Services, QPPMIPS

There have been delays reported in terms of accessing the diagnostic procedures of COVID-19. The delays and shortage in facilities may affect the frontline fighters (physicians), and ultimately potential patients.

According to AMA, the newly released code is a progressive step towards optimal coronavirus diagnostic services. All along, the physician or medical billing company is required to use the Healthcare Common Procedure Coding System (HCPCS) codes to document public encounters with the health payment programs as Medicare.

The Centers for Medicare and Medicaid Services (CMS) also stated to create two new HCPCS codes to support the coronavirus diagnostic procedure.

The first code released in February (U0001) is for SARS-CoV-2 diagnostic tests performed specifically for CDC testing laboratories.

The second billing code (U0002) released this month will extend medical billing services for coronavirus lab tests, allowing to bill for non-CDC laboratory tests for SARS-CoV-2/2019-nCoV, (novel coronavirus or COVID-19).

QPP MIPS requests everyone to stay strong and be mindful of others around you. Spend this difficult time to connect with yourself and be creative while staying home.  You never know who carries the virus therefore, use hand sanitizers, clean your space, wear gloves, and face mask before going out and keep a safe distance from everyone.

coronavirus, medical billing service, healthcare industry, Coronavirus global threat, global health emergency, coronavirus vaccine, virus in China

Jackie Chan: 1 Million Yuan for Whoever Finds the Cure

Famous movie star Jackie Chan who needs no introduction has promised an amount of 1 million yuan for developing a vaccine for coronavirus. Since the virus is still very much around, especially around the city of Wuhan, it is a call to researchers, inventors, scientists, pharmacists, chemists, and biologists to come up with a remedy. A miracle vaccine!

Somehow finding its way to the Chinese population, the virus has taken hundreds of lives in a matter of days. Unable to find a solution until now, it has spread like wildfire in over 25 countries. According to the veteran actor, he feels for his fellow men and women and anyone who has succumbed to the deadly coronavirus.

No less than a million yuan is quite an incentive for the thinking brains out there to work their magic and invent an antidote. It is not about the money for Jackie Chan or the people he is calling on for a solution.

We are confident that it will happen anytime soon because that is what we want. Not only does human suffering is painful to see but it puts the responsibility on us to unite on this very cause. The cause is to find relief against coronavirus once and for all.

Jackie Chan’s stance

“Science and technology are key to overcoming the virus, and I believe many people have the same thought like me and hope that an antidote can be developed as soon as possible”, the actor declared.

He continued, “I have a ‘naive’ idea now. No matter which individual or organization develops the antidote, I want to thank them with 1 million yuan”.

He stressed the fact that he doesn’t want people to suffer from the virus when they should be enjoying life. And it is not about the money but the people.

Back at home during the medical masks and protective gear emergency, the actor was among the people who donated generously. It goes to show this guy is exactly how he looks like; a person with a heart of gold.

Kicks and nunchakus for coronavirus

coronavirus, medical billing service, healthcare industry, Coronavirus global threat, global health emergency, coronavirus vaccine, virus in China

World Health Organization (WHO) has declared it a global health emergency. Whether coronavirus likes it or not, it has to face the likes of Jackie Chan and the world of martial arts knows that if he sets his mind to something, he is unstoppable. Get ready to face round-house kicks because the attack mode is on which will not stop until it is defeated.

Background

The origin of this virus is still unknown; however, the Chinese city of Wuhan, located in the province of Hubei is under attack since December 2019. The area has been discussed so many times in the past that most of us have memorized it by now. However, it is of utmost concern to come up with a remedy.

All the efforts are being done to create a vaccine that neutralizes it in the system of an infected person. Most probably, the ideas will form into a permanent solution any day now.

Peace to the world

coronavirus, medical billing service, healthcare industry, Coronavirus global threat, global health emergency, coronavirus vaccine, virus in China

As of now, 780 people have died of this virus in China and a large number of people (over 37,000) are infected from it both in and out of the country. God bless the people as we hope to God to shower His peace and blessings from eternal heavens and wipe this menace of the face of the earth.

Conclusion

P3Care medical billing service supports any research efforts being done around the world against coronavirus. We may fail once; we may fail twice, but if we continue to look for a vaccine, ultimately, we will have one. The healthcare industry in the US is as concerned as anyone else. US government organizations such as the CDC have reassured the Chinese government that they are always ready to help.