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Author: Lauren Brown

Mid-Week MACRA Minute – QPP Hardship Exemption Application

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Helping you put the MIPS pieces together each week! The Quality Payment Program (QPP) 2017 Hardship Exemption Application is NOW OPEN! What do you need to know? MIPS eligible clinicians and groups may qualify for a reweighting of their Advancing Care Information performance category score to 0% of the final score, and can submit a hardship exception application, for one of the following specified reasons: Insufficient internet connectivity Extreme and uncontrollable circumstances (***see below for…
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Mid-Week MACRA Minute – Track your 2017 MIPS Reporting Progress

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Helping you put the MIPS pieces together each week! Quality & Advancing Care Information Summary Reports in MediSYS EHR It’s important track your percentages for the Quality Measures & Advancing Care Information performance categories of MIPS. Regularly tracking your percentages for these measures will make reporting for MIPS in 2017 more successful and potentially earn your clinic an incentive! MediSYS EHR provides tools for tracking both Quality measures and Advancing Care Information measures so you will know where you…
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Mid-Week MACRA Minute – Advancing Care Information Tips n Tricks

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Helping you put the MIPS pieces together each week! Advancing Care Information: Tips ‘n’ Tricks We created a list of a few tips on the Advancing Care Information (formerly Meaningful Use) performance category for 2017. Remember, the Advancing Care Information (ACI) category counts for 25% of your 2017 MIPS Performance score. Tips ‘n’ Tricks: Make sure you choose the right ACI measure set to report on. This will depend on which version your EHR software is certified; 2014 or…
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Delayed: Bundling by Tax ID and Specialty Claim Edits Standardization

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The following information has been posted to the Blue Cross and Blue Shield of Alabama website: Delayed: Bundling by Tax ID and Specialty Claim Edits Standardization On June 27, 2017, a notification was distributed regarding an August 1, 2017, implementation date to apply bundled edits to all providers under the same Tax ID with the same specialty. This is currently on hold. A new communication will be sent once a new date is available.  

Mid-Week MACRA Minute – Improvement Activities Tips n Tricks

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Helping you put the MIPS pieces together each week! Improvement Activities: Tips ‘n’ Tricks We created a list of a few tips on the Improvement Activities performance category for 2017.  Remember, the Improvement Activities category counts for 15% of your 2017 MIPS Performance score. Tips ‘n’ Tricks: The maximum score for the Improvement Activities (IA) category is 40. Each Improvement Activity is weighted differently and the weight determines the points that you will receive for completing the activity:…
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Qualified Medicare Beneficiary (QMB) Indicator in the Medicare Fee-For-Service Claims Processing System

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QMB is a Medicaid program that assists low-income beneficiaries with Medicare premiums and cost sharing. Effective Date: For claims processed on or after October 2, 2017 Summary of Changes: Creates an indicator of Qualified Medicare Beneficiary (QMB) status in the claims processing systems. Beneficiaries enrolled in the QMB program are not liable to pay Medicare cost-sharing for all Medicare A/B claims. The new claims processing systems QMB indicator will trigger notifications to providers (through the…
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Mid-Week MACRA Minute – Quality Measure: Tips n Tricks

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Helping you put the MIPS pieces together each week! Quality Measures: Tips ‘n’ Tricks We created a list of a few tips on how to successfully attest for the Quality Measures performance category in the 2017. Tips ‘n’ Tricks: Quality Measures are NOT restricted by specialty. Only 1 reporting mechanism can be used to report the Quality Measures performance category of MIPS. Attest to more than one Quality Measure or Improvement Activity to provide additional…
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Mid-Week MACRA Minute – Quality Measure 226: Preventive Care and Screening: Tobacco Use

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Helping you put the MIPS pieces together each week! Quality Measure 226 – Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention CMS made some changes to Quality Measure 226 and we have highlighted those changes below. Description: Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user NEW DENOMINATOR/NUMERATOR CRITERIA…
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Changes to Alabama Medicaid RHC Billing Effective January 1, 2018

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Attention Independent Rural Health Clinic (IRHC) Alabama Providers: Effective January 1, 2018, Alabama Medicaid will no longer allow IRHC providers to bill a small range of services for the encounter rate. IRHCs will need to bill the actual procedure code for the services performed instead of billing a limited range of codes, such as 99211-SE and 99231-SE. IRHCs will need to refer to the CPT code book and bill the most appropriate code to reflect…
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Mid-Week MACRA Minute – PROPOSED Changes for 2018

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Helping you put the MIPS pieces together each week! Have you seen the PROPOSED MIPS changes for 2018? View the full PROPOSED Rule for the 2018 Performance Period at https://qpp.cms.gov/about/resource-library. The 60 day comment period on the proposed rule will end on August 21, 2017. Below are some of the highlights from the 2018 PROPOSED rule for MIPS: Raising the low-volume threshold to exclude individual MIPS eligible clinicians or groups who bill less than or equal to $90,000…
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Mid-Week MACRA Minute – Data Validation & Auditing

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Helping you put the MIPS pieces together each week! MIPS Data Validation and Auditing CMS is required by the Quality Payment Program Final Rule with comment, to provide the criteria they will use to audit and validate measures and activities for the 2017 transition year of MIPS for all performance categories: Quality, Advancing Care Information and Improvement Activities. According to CMS, data validation is the process of ensuring that a program operates on accurate and useful data. MIPS…
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PROPOSED 2018 MIPS and APM changes

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On June 20, 2017, the Centers for Medicare & Medicaid Services (CMS) released the PROPOSED RULE for the 2018 Quality Payment Program, which includes the Merit-Based Incentive Payment System (MIPS) and alternative payment models (APMs) participation options and requirements. The Medicare Access and CHIP Re-authorization Act of 2015 (MACRA) requires that the Quality Payment Program is reevaluated and updated annually. The proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians…
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