decisionhealth Newsletters, Part B News - 2008 Issue 5 (May)
Your PQRI incentive checks will be on the way, soon …
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Article Overview
This article reviews CMS updates discussed with the Practicing Physicians Advisory Council, with emphasis on the Physician Quality Reporting Initiative, Medicare claims administration, and related physician practice policy issues. It is aimed at physicians, coding and billing staff, practice managers, and compliance professionals who need to follow Medicare reporting, payment, and operational changes. The coverage includes general program status, organizational actions, and pending policy questions affecting reporting, claims processing, and provider participation.
Why This Topic Matters
The article helps readers track Medicare program changes that can affect reporting workflows, payment timing, claims submission, and administrative planning in physician practices.
Article Sections
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PQRI payment timing and program status
Discusses CMS updates on the first-year reporting initiative and the timing of incentive payments. Also covers participation statistics and related program context.
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Physician compare site and public reporting concerns
Summarizes council discussion about a potential physician comparison website and the handling of physician-specific reporting information.
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RAC review of E/M services
Addresses the status of Medicare contractor review of evaluation and management services and related organizational commentary.
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Pay fix still looms
Covers the pending Medicare physician payment update issue and related calls for longer-term formula reform.
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DMEPOS bidding and accreditation
Reviews accreditation and competitive bidding issues tied to durable medical equipment, prosthetics, orthotics, and supplies in the Medicare setting.
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NPI-only claims deadline
Summarizes PPAC discussion of claims submission changes, legacy numbers, and monitoring of denials during the transition to NPI-only claims.
What You Will Learn
- The scope of CMS updates on physician reporting and incentive payment timing
- Which Medicare operational issues were discussed alongside PQRI
- What policy topics PPAC raised regarding claims processing and provider identification
- How Medicare administrative changes may affect physician practices and billing workflows
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Practice managers
- Compliance professionals
- Healthcare administrators
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