decisionhealth Newsletters, Part B News - 2012 Issue 4 (April)
E-Rx penalty final in most cases, but it doesn’t hurt to call QualityNet
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Article Overview
This article explains CMS’ handling of the 1% e-prescribing penalty and the limited role of the QualityNet Help Desk in reviewing related questions. It is aimed at medical billing and practice management professionals who need to understand the general appeal landscape, the type of documentation CMS may review in rare circumstances, and why some penalty issues are not formally appealable through QualityNet.
Why This Topic Matters
It helps practices and billers understand whether an e-prescribing penalty can be challenged, what QualityNet can and cannot do, and the kinds of situations CMS may review outside the usual process.
What You Will Learn
- How CMS and QualityNet handle questions related to the e-prescribing penalty
- What kinds of circumstances CMS may review for possible penalty reversal
- Why documentation matters when a practice believes a penalty was applied in error
- Why some reported e-prescribing issues may not be correctable through a formal appeal
Who Should Read This
- Medical billers
- Coding professionals
- Practice managers
- Revenue cycle staff
- Healthcare administrators
Codes Discussed
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