decisionhealth Newsletters, Part B News - 2011 Issue 3 (March)
CMS clarifies how it will use prior claims data to dole out primary care bonus money
Subscribe or sign in to view the full article.
Article Overview
This article covers CMS guidance on the Primary Care Incentive Payment (PCIP) program and how the agency distinguishes between eligibility screening and payment calculation. It is intended for physicians, group practices, coders, and billing staff who need to understand the general framework CMS is using for bonus payments, the timing differences between provider groups, and the contractor posting process for eligible providers. The article also discusses the broader administrative context of the program and its annual data lookback approach.
Why This Topic Matters
PCIP affects Medicare bonus payment eligibility and timing for qualifying primary care providers. Understanding CMS’s process helps practices anticipate whether they may be included and how payment amounts are determined under the program.
What You Will Learn
- How CMS uses prior claims data to determine program eligibility
- How current-year billing affects bonus payment amounts
- How CMS distinguishes between established and newly enrolled providers
- How payment timing differs across provider groups
- What administrative steps CMS requires contractors to take for public posting of eligible providers
Who Should Read This
- Physicians
- Primary care practices
- Medical coders
- Billing staff
- Practice administrators
- Medicare compliance staff
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com