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Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

APTA Surveys Physical Therapists against Telehealth

Perhaps the most dramatically impacted area of healthcare as a result of the coronavirus pandemic is telehealth. Previously, the conditions were not in favor of virtual clinics because face-to-face visits were the norm. Now, however, the situation has changed. When other clinicians are making use of telemedicine, PTs and PTAs are, definitely, not far behind.

On March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) allowed PTs to conduct e-visits after which they can reach patients at homes keeping them away from the contagious virus. But it wasn’t easy, to say the least – It took a lot of effort.

It was not until April 30, 2020 – after rigorous advocacy by APTA – that CMS decided to include PTs and PTAs among providers eligible to bill for telehealth services. Such services include virtual visits contrary to real-time, face-to-face meetings.

In other words, COVID-19 persuades the government to make PTs and PTAs eligible for remote patient management, which results in a rapid increase in telehealthcare.

Increase in Video Consults via Live Sessions

Before the pandemic, 98% of physical therapists questioned did not do live video sessions with their patients. Furthermore, out of 2% who did, 69% of them saw only one patient per week on average. As a result of this awful virus, we saw 50% of PTs adopting live video sessions as an outlet to see their patients. In a matter of months, most of the physical therapy switched from real-time visits to remote visits.

Generally speaking, medical billing services, under the new world order, have to readjust keeping in view the regulatory and federal guidelines specifically for e-visits.

One of the PTs said, and I am paraphrasing it: Some of the aspects of video visits are a revelation – seeing positions of patients while they sit and watch TV or examining their postures of sleep. They would like to continue with live video sessions as part of their treatment even after the pandemic.

Uncertainty with Telehealth Billing Returns

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

The survey by APTA brought vital information to the limelight. Of those PTs who participated in this survey, 25% of them were sure their telehealth payments were consistent with in-person visits, while 53% were not sure of it. Similar, uncertainty was there when it came to patient satisfaction with telehealthcare.

As much as there is uncertainty in life, there is vagueness to practicing medicine online because we are all new to it. However, for consistent revenue cycle management, we must adhere to local and federal instructions for telehealth as we follow the HIPAA code of conduct in terms of PHI safety.

There is no denying the fact that telehealth has emerged as a blessing in disguise in these challenging times. When elective medical procedures were restricted, this facility helped many physicians to make up for the loss.

Yes! There were issues related to technology familiarization, but in most cases, there was relief that doctors were available for you. It was particularly beneficial for patients with chronic health conditions, who require regular monitoring.

Zoom to Meet and Treat

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

The survey showed Zoom as the most popular platform for video consults, according to 43% of the participating PTs. APTA’s June 2020 report covers the impact of COVID-19 on physical therapy. We deduce these results from it. The rest of the practitioners among the participants reported using more than a dozen other platforms for video care.

The graph below shows the usage of virtual platforms since the pandemic spread in the US.

Technology Is Both A Blessing and Burden

Technology, on one side, is the facilitator, but on the other, an obstacle. 31% of practitioners said their patients were not technologically ready for an e-visit, while 21% of the PTs said their facility lacked the technology to facilitate patients during the pandemic.

Another common barrier faced by PTs and PTAs was the lack of payments for telehealth services. Telehealth billing services by P3Care supports physical therapists to get them higher reimbursements, fewer accounts receivable, and responsive customer support. Besides, we apply tools and techniques to take our clients up the road of virtual visits resulting in better collections.

Below, you’ll see a graph of what obstacles our PTs face against technology, courtesy APTA’s June 2020 report.

Medical billing services, Telehealth billing services, MIPS consulting, P3Care, Revenue cycle management

Conclusion

PTs and PTAs are part of the frontline workers of the COVID-19 emergency response that have been crucial to the healthcare teams, providing care in private clinics, facilities, nursing homes, and hospitals nationwide. Moreover, it is due to their constant support that the patients in local community settings not affected by COVID-19 receive continuous care.

Mobility, strength, consistency, and patience are fundamental elements of physical therapy in any setting. PTs and PTAs help patients get well sooner with their expertise in musculoskeletal conditioning. Unquestionably, the role of PTs is vital to see us through the COVID-19 pandemic.

Note: At all times, the CDC recommends PPE for the safety of patients and therapists alike.

A Guide to MIPS 2019 Reporting for Physical Therapists is where you can find MIPS consulting essentials for the previous year leading to the year 2020.

MIPS reporting in 2019, Physical Therapist, MIPS meaningful use, healthcare system, Quality Payment Program, QPP, MIPS Qualified Registry, Medicare & Medicaid Services, Healthcare Solutions, CMS

A Guide to MIPS 2019 Reporting for Physical Therapists

Physical therapists are included as one of the groups of healthcare practitioners eligible for MIPS reporting in 2019. It was time their duties were rewarded with an open heart and a clear head. Physical therapy is a serious branch of medicine that, now, comes in the quality circle of the government where physical therapists (PTs) can receive incentives based on their performances. Moreover, MIPS measures relevant to their line of work highlight the broader spectrum of the US healthcare system.

Merit-Based Incentive Payment System (MIPS), as some of the PTs must already know, is where the disadvantaged gets rewarded equally as one with advantages. By advantages, I mean those clinicians who have to face geographical constraints or practices working in the countryside where there are fewer facilities as compared to ones in the city.

So, a system that speaks of justice is a system that works for people everywhere in the world.

MIPS is a combination of programs such as the Physician Quality Reporting System (PQRS), the Meaningful Use (MU) program and the Value-Based Modifier (VBM). Promoting interoperability (PI) category correlates with the MIPS meaningful use.

The four categories in which the performance of clinicians and clinician groups are measured are –

  • Quality,
  • Promoting Interoperability (PA),
  • Improvement Activities (IA),
  • And, Cost

Generally, PTs will only be scored in two categories in 2019 – Quality and Improvement Activities. The American Physical Therapy Association (APTA) participates actively in every provision of the Quality Payment Program (QPP).

MIPS 2019 Reporting for Physical Therapy Made Easy by P3Care

With the pre-designed MIPS 2019 reporting packages in the form of MIPS Essentials, MIPS Budget Neutral and Benchmark MIPS, P3 Healthcare Solutions is tailor-made for it. Doctors falling across various specialties, now, adopt one of these packages to report data. Their MIPS final scores in the 80s and 90s are a clear manifestation of the efficiency of P3 Healthcare Solutions.

Give it a try by talking to us at this number: 1-844-557-3227.

Being a MIPS Qualified Registry gives us an edge to report with consistency and data completeness. The latter qualifies as one of the factors judging the quality of data by the Centers for Medicare & Medicaid Services (CMS).

The Deadline

Another important factor that keeps us on the edge of our seats is deadlines. In this case, Physical Therapists (PTs) can report MIPS measures until December 21 as far as improvement activities are concerned. However, the submission of Quality occurs all over the year, P3 Healthcare Solutions, Ontario, CA has done it in the past and continues to report MIPS Quality measures for eligible clinicians year after year.

Submission deadlines vary according to the submission types. For those who undergo MIPS claims-based reporting in 2019, the claims must get processed “no later than 60 days after the performance year ends”. Groups using the CMS web interface option have to submit within 8 weeks after the performance year. The time window for this 8-week reporting opens from January 2 to March 31.

As a general rule, participants must submit measures before March 31 of the year after the performance year.

MIPS Consulting Services with Results

Physical Therapists (PTs), Occupational Therapists (OTs) and Speech-Language Pathologists (SLPs) are three crucial branches of health care. All of them can make use of P3Care to report MIPS performance categories, score high, and get a chance at incentives. That’s right. Leverage our services to convincingly compete in the Quality Payment Program 2019.

Improvement Activities (IA) category measures their performance in terms of practice improvement over an elaborate period. Ideally speaking, a MIPS Qualified Registry is suitable for reporting IA for

PTs and OTs as they can work on measures such as enhancing care coordination, expanding patient access to care, and improving patient-doctor decision-making. All of this to land the best score out of a total of 40 points.

How to Avoid Penalties in MIPS 2018, 2019 and Beyond?

Please comment to assist the other readers.

Laying Down The Numeral Facts Of MACRA-MIPS

MIPS a value-based reimbursement model activates under MACRA by the Centers for Medicare & Medicaid Services (CMS) to promote quality and cut down the cost of healthcare. It is an opportunity for medical professionals to choose quality over quantity, effectively deliver, and in return, earn some incentives. The positive payment adjustments await only those with scores higher than 15 out of a total of 100 points.

To stay updated on the QPP, follow us on our LinkedIn page – https://www.linkedin.com/company/p3-healthcare-solutions/

For scores above 70, bonuses are likely to happen from the $500 million pool of money reserved only for the top performers. If you look closely, the program benefits all, the doctors, the insurance companies and most of all, the patients who are at the receiving end.

The Composite Performance Score (CPS) determines the overall performance of each practitioner when they report measures for four performance categories under the Quality Payment Program 2018.

Minimum Requirements of MIPS 2017

We saw the practical implementation of MIPS in 2017! The year 2017 was also the transition period to settle things down slowly and gradually. In 2018, the eligible practitioners are quite aware and implement the procedures to qualify for incentives, bonuses or simply to avoid penalties at the start of 2020.

There is a change in the set of rules for 2018. Each of the categories influencing the MIPS final score undergoes an increase in the number of measures. QPP 2018 is a chance for you to show brilliance in terms of quality of care and earn incentives along with a solid reputation in the healthcare industry.

Quality covers 60%, Improvement Activities (IAs) 25%, and ACI or meaningful use carries 15% of the total score. A MIPS Final Score of 3 or above would save them from negative adjustments in 2019.  It included reporting on 1 Quality measure, 1 Improvement Activity or all the Advancing Care Information (ACI) measures.

It was only recently that CMS published the scores of 2017 on their QPP portal.

Basic Requirements in 2018

In MIPS 2018, the Quality covers 50%, Improvement Activities (IAs) 15%, Promoting Interoperability (ACI or meaningful use) 25%, and Cost, the new category, makes up to 10% of the final score.

In 2018, the rules are changed and the stakes are higher now. The EPs need 15 points to make it to the safe zone and avoid a higher penalty (up to 5% of the Medicare Part B payments) in 2020. To achieve this score, you must successfully attempt 2-3 Quality measures, 4 Improved Activities or perform all the ACI base measures.

MIPS Qualified Registry like P3Care only takes a few of your minutes to shortlist those measures.

Mathematical Side of MIPS

Quality holds significance as a performance parameter for MIPS 2018. It adds to the total score by assessing how well the practitioners perform measures in terms of their practice or their field of expertise. The practitioners review the list of measures and select only those best suited to their practice.

For specialists, there are specialty-specific measure sets. In 2017, there were 30 specialty measure sets. Some sets have fewer measures and some have more, but you have to complete only those related to your specialty. For sets containing more than 6 measures, you must cater to those 6 and complete an outcome measure or a high-priority measure, additionally.

Topped Out Objectives

There are 6 topped out Quality measures identified by CMS in 2018. The measures identified as ‘topped out’ means that the eligible physicians are no longer able to score more than 7 in them. Performance for these measures is usually high and completing them does not mean improvement in the quality of service.

Multiple Measure Options for Eligible Clinicians in 2018

Quality – CMS website displays 271 measures from which you can select six of your choice with one outcome measure or a high-priority measure.

Improvement Activities (IA) – Report up to 4 measures to achieve a score of 40 points in this category.

Promoting Interoperability (PI) – The category was Advancing Care Information (ACI) or meaningful use the year before. ECs must report all 4 base measures to achieve a maximum score. Select from among the seven measures.

Cost – Medicare Spending per Beneficiary (MSPB) is at stake here and it has zero measures for you to report. CMS will deduce the score itself by analyzing the claims data of the practitioner.

Hard Work Pays Off

Successful execution of all these performance categories can earn you 15 points and save you from the penalty in 2020. However, when you complete more than 6 or 7 measures along with a few outcome measures or high-priority measures, you make yourself eligible to bonuses from the $500 million pool. The bonus payments keep on increasing with each passing MIPS evaluation period.

The 70 points will earn you a place in the elite class of doctors and practitioners who give maximum attention to their patients. They care for them to the best of their ability, and in return reap the profits. In doing so, they take the US healthcare system one-step closer to glory.

Everybody is a Winner                      

QPP 2018 has something for everyone. The clinicians reap the rewards in terms of positive payment adjustments, the patients go home feeling well, and the government feels the pride in its policy structure.

MIPS 2019 – A Brief Overview

We have gone one step ahead. Now in the 3rd performance year of MIPS, the percentage of all performance measures has changed as follows.

MIPS penalty level has gone to -7% and the minimum score to avoid a penalty is 30 points.

The scores for each performance category are:

  • Quality 45%
  • Promoting Interoperability 25%
  • Improvement Activities 15%
  • Cost 15%

Every eligible clinician who reports for Medicare Part 2 or Critical Access Hospital (CAH) Method II payments can participate in MIPS 2019.  Moreover, every clinician can report as a group or as an individual but it applies across all categories.

It means, if a clinician chooses to report individually, he can report solely with this submission method for all categories.

Eligible clinicians have lots of chances to earn incentives and bonuses in this year by performing well for interoperability and maintaining quality.

The resulting situation brings down healthcare expenses and improves efficiency. Everybody gets to be a winner.

We are an approved MIPS registry to report data on your behalf. Dial 1-844-557-3227 (1-844-55-P3CARE) or email at info@p3care.com to talk to a trained HIT consultant.