decisionhealth Newsletters, Answer Books - 2009 Issue 6 (June)
Answer_Book / Quality_Reporting_Initiatives / PQI Old sections / 3 tips to make reporting easier
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Article Overview
This article explains practical considerations for practices that are beginning or refining participation in physician quality reporting and e-prescribing initiatives. It is aimed at administrators, billers, coders, and clinicians who want a high-level understanding of how reporting workflows, encounter selection, and claims processing can affect Medicare incentive participation and payment adjustments. The piece discusses broad implementation tips, references CMS-related reporting concepts, and identifies the kinds of encounter types and system issues that may affect reporting.
Why This Topic Matters
Understanding the article helps a practice evaluate whether it is relevant to its quality reporting workflow and Medicare incentive strategy. It highlights operational areas that can affect whether reporting data is captured and transmitted correctly without exposing the underlying premium coding guidance.
Article Sections
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3 tips to make reporting easier
An overview of practical advice for practices beginning quality reporting and e-prescribing participation. The section frames the topic in the context of Medicare reporting and incentive-related workflow.
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Tip: Don't drastically change physician services when you first attempt reporting
Guidance on starting with reporting efforts that align with existing practice operations. The section uses a broad quality-measure example to illustrate implementation planning.
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Tip: Make it as simple as possible, especially for the provider
Discussion of simplifying documentation and encounter reporting processes for providers. The section addresses common visit categories, system workflow, and claim capture considerations related to e-prescribing reporting.
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Tip: If you use a claims scrubber
A workflow-focused note on claims-processing edits and how automated claim review tools can affect reporting data. The section centers on preserving reporting information when claims are submitted.
What You Will Learn
- How quality reporting and e-prescribing efforts fit into a Medicare-focused practice workflow
- What operational issues can affect whether reporting data is captured correctly
- Why claims-processing tools may influence reporting outcomes
- Which broad encounter categories are discussed in relation to reporting readiness
Who Should Read This
- Physician practice administrators
- Medical coders
- Medical billers
- Compliance staff
- Clinicians participating in quality reporting
Codes Discussed
Code Ranges Discussed
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