decisionhealth Newsletters, Part B News - 2008 Issue 12 (December)
2007 PQRI reporters to get a second chance at earning bonus
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Article Overview
This article covers CMS guidance and program updates related to the Physician Quality Reporting Initiative (PQRI), including how reporting will be evaluated for Part B bonus eligibility and how prior-year claims are being reviewed. It is relevant to physicians, group practices, and billing/coding staff who track quality reporting requirements and Medicare incentive programs. The piece also summarizes CMS-identified reporting issues and system changes affecting claims processing and diagnosis capture at a high level.
Why This Topic Matters
Providers participating in PQRI need to understand how CMS is reassessing reporting data, because it can affect whether incentives are paid and how future reporting is evaluated. The article helps readers follow Medicare quality-reporting administration changes without relying on the full report.
What You Will Learn
- How CMS is revisiting prior PQRI reporting results
- What general types of claims-processing issues CMS identified
- Why diagnosis capture on claims is being reviewed for quality reporting
- How the timing of bonus payments is being handled
Who Should Read This
- Physicians
- Group practices
- Medical coders
- Billing staff
- Quality reporting staff
- Practice administrators
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