decisionhealth Newsletters, Part B News - 2013 Issue 7 (July)
Check whether administrative claims measures apply before signing up
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Article Overview
This article reviews guidance for physicians and practices considering CMS’s administrative claims-based PQRS reporting option. It covers the general purpose of the program, the timing and registration steps involved, the role of the IACS and PV-PQRS systems, and the cautions raised by consultants, MGMA, and CMS about measure applicability and possible payment adjustments. The piece is relevant to billing staff, practice managers, and compliance teams evaluating PQRS participation options.
Why This Topic Matters
Practices considering PQRS participation need to understand whether the administrative claims option is actually applicable to their services and specialty before relying on it as a path to avoid a payment adjustment. The article helps readers assess registration logistics, program timing, and the kinds of CMS guidance that affect reporting decisions.
What You Will Learn
- The purpose of the administrative claims-based PQRS reporting option
- How the registration process is structured at a high level
- Why measure applicability matters before enrollment
- What general concerns CMS and outside experts raise about relying on this option
- How practices may evaluate alternative PQRS reporting approaches
Who Should Read This
- Physician practices
- Billing departments
- Practice managers
- Compliance staff
- Medical coders
- Revenue cycle teams
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