decisionhealth Newsletters, Part B News - 2018 Issue 4 (April)
Check the MIPS participation tool, but don’t ignore unexpected results
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Article Overview
This piece covers CMS’s Quality Payment Program participation lookup tool for determining MIPS status in 2018. It is aimed at clinicians, practice staff, and coding/billing professionals who need to verify whether a clinician or group is subject to MIPS and understand the tool’s limitations, troubleshooting notes, and support resources. The article also notes that a related lookup tool for alternative payment model clinicians was still in development at the time.
Why This Topic Matters
Accurate MIPS participation status affects whether clinicians and practices need to meet reporting obligations and avoid future payment adjustments. The article highlights that the lookup tool is helpful but not definitive, so users should know when to question results and where to seek clarification.
What You Will Learn
- Who the CMS MIPS participation lookup tool is intended for
- Which clinician categories are generally included in MIPS for the year discussed
- What types of information the tool may return about a clinician or practice
- Why users should verify results that do not match expectations
- Where to find help if participation status is unclear
- What related CMS lookup tool was in development at the time
Who Should Read This
- Medical coders
- Billing and reimbursement staff
- Practice managers
- Clinicians participating in the Quality Payment Program
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