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MIPS Promoting Interoperability hardship exception now available

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MIPS Promoting Interoperability hardship exception now available – Submit today, don’t wait! For 2018 MIPS, eligible clinicians can submit a QPP Hardship Exception Application to have the Promoting Interoperability (PI) performance category (formerly ACI) reweighted to 0 percent citing one of the following reasons: Small practices (15 or fewer clinicians) NEW for 2018 Using decertified EHR technology NEW for 2018 Insufficient Internet connectivity Extreme and uncontrollable circumstances Lack of control over the availability of CEHRT Application…
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MACRA Minute – Request your MIPS Targeted Review Today

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Helping you put the MIPS pieces together each week! October 1 is the deadline to request a MIPS Targeted Review – But Don’t Wait! A targeted review is a process where MIPS ECs can request CMS review their 2017 MIPS participation year calculations. If you suspect there are errors or data quality issues with your 2019 payment adjustment then don’t delay! Confirm you have an Enterprise Identity Management (EIDM) account today and log in to…
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MACRA Minute – Exclusion vs. Special Status for 2018 MIPS

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Helping you put the MIPS pieces together each week!   Difference between Exclusions and Special Statuses for 2018 MIPS EXCLUSION means you are EXEMPT from participation in MIPS and therefore will not receive a negative or positive payment adjustment. These include: Newly enrolled to Medicare (enrolled during the performance period) Below the low-volume threshold which means: Medicare allowable covered charges less than or equal to $90,000 a year OR 200 or less Medicare part B patients…
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Annual Wellness Visits

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By Carrie Gulledge RHIA, Director of Electronic Health Records and Jennifer Woodward, Director of Operations with MediSYS   As today’s healthcare drive pushes practices even further down the path of pay for performance versus the older models of pay for volume, administrators and executives throughout healthcare are researching and implementing ideas to provide an overall better experience for patients. Medicare’s Annual Wellness Visits have become one way CMS has encouraged better patient care and follow-up….
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MACRA Minute – Low-Volume Threshold Determination Periods

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Helping you put the MIPS pieces together each week! Deeper look into the low-volume threshold determination periods for MIPS Eligibility in 2018 From the 2018 MIPS final rule, the low-volume threshold determination period is a 24-month assessment period consisting of: An initial 12-month segment that spans from the last 4 months of the calendar year 2 years prior to the performance period through the first 8 months of the calendar year preceding the performance period; AND A…
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MACRA Minute – Check your 2018 MIPS Eligibility Status Now

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Helping you put the MIPS pieces together each week! Updated Look-up Tool on QPP Website for 2018 MIPS Eligibility CMS has just released an updated look-up tool on their QPP website that enables clinicians to determine whether they must participate in the Merit-Based Incentive Payment Program (MIPS) this year. Visit www.qpp.cms.gov/participation-lookup and enter the Clinicians’ National Provider Identifier (NPI) number to find out whether they are eligible to participate in MIPS during the 2018 performance year. Reminder…
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Palmetto GBA Incorrect Claim Rejections- Group NPI and Rendering Provider NPI Do Not Match

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Issue Identified 3/19/2018 Palmetto GBA is aware that certain Jurisdiction J Part B claims rejected incorrectly when the billing (group NPI) and rendering provider (individual NPI) combination were submitted correctly. Affected claims incorrectly rejected with: Claim Adjustment Reason Code CO-16 (Claim/service lacks information or has submission/billing error(s) and Remittance Advice Remark Code N290 (Missing/incomplete/invalid rendering provider primary identifier) While Palmetto GBA continues to research the issue, a temporary workaround has been implemented to prevent claims…
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The Providers Role in the New Medicare ID Transition

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by Jane Ehrhardt Published: February 14, 2018 in the Birmingham Medical News “The one thing doctors should be doing is making sure their patients have their address correct with Medicare,” says Phillip Allen, billing service manager with MediSYS. “The patient won’t get a new card if their address is not correct.” This simple reminder could diminish ongoing problems for providers in the massive transition underway to distribute new Medicare ID numbers. Since its inception in…
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Mid-Week MACRA Minute – December 31 DEADLINES

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Helping you put the MIPS pieces together each week! DECEMBER 31st Deadlines: Quality Payment Program (QPP) 2017 Hardship Exception Application for the ACI category Virtual Groups Registration for 2018 MIPS Participation Security Risk Analysis for 2017 MIPS Participation See below for details on each of these deadlines: The Quality Payment Program (QPP) 2017 Hardship Exception Application for the ACI Category MIPS eligible clinicians (ECs) and groups may qualify for a reweighing of their Advancing Care…
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Mid-Week MACRA Minute – ACI Measures that no longer have an exemption

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Helping you put the MIPS pieces together each week! It’s not too late to finish strong with MIPS reporting in 2017! In this week’s MACRA Minute, we want to point out a few measures that no longer have an exemption available for 2017 reporting! In the 2017 Advancing Care Information (ACI) Transition Objectives and Measures category: Objective 6 – Health Information Exchange There is no longer an exemption. In previous years, if there were less than…
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Mid-Week MACRA Minute – Virtual Groups for 2018 MIPS Participation

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Helping you put the MIPS pieces together each week! Virtual Groups for 2018 MIPS participation What is a Virtual Group? Virtual Groups is a new participation option for year 2. (**NOTE this is only for 2018 MIPS participation) A virtual group consists of 2 or more TINs including solo providers or groups of 10 or less ECs who work together, no matter specialty or location, to participate in MIPS. virtual groups will benefit small and…
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Mid-Week MACRA Minute – Security Risk Assessment

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Helping you put the MIPS pieces together each week! The importance of having and maintaining an up-to-date Security Risk Assessment Security risk assessments have been required for the past 12 years and it was also a requirement of the Meaningful Use program in previous years. HIPAA requires that covered entities conduct a risk assessment of their healthcare organization to help ensure compliance with HIPAA’s administrative, physical, and technical safeguards. A risk assessment also identifies areas…
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