decisionhealth Newsletters, Coder Pink Sheets - 2018 Issue 7 (July)
Quality: Conduct a mid-year MIPS check-up of your clinicians’ quality efforts
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Article Overview
This article explains how practices can review their clinicians’ quality reporting halfway through the MIPS performance year, especially when reporting through claims. It covers the general structure of claims-based quality measures, how practices can audit submissions at a high level, and why timely internal checks matter for MIPS participation and score protection. The content is aimed at clinicians, coding staff, quality teams, and practice administrators who help monitor MIPS quality performance.
Why This Topic Matters
Mid-year review can help practices confirm whether clinicians are tracking toward required quality reporting expectations and identify issues before the reporting year ends. It is relevant for teams responsible for MIPS compliance, claims-based measure submission, and internal quality monitoring.
Article Sections
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Mid-year MIPS quality review
Introduces the purpose of a halfway-point check-in for the quality component of MIPS and the importance of reviewing claims-based reporting progress.
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Review measures first, then claims
Describes the general elements of claims-based quality measures and how practices can organize an internal review of measure performance and submission patterns.
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Be ready to act on findings
Covers the need to address reporting gaps during the performance year and to follow up on clinician reporting behavior after making corrections.
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Resources
Lists supporting tools and reference files related to MIPS participation and claims-based measures.
What You Will Learn
- How to perform a mid-year review of claims-based MIPS quality reporting
- What general components appear in claims-based quality measures
- Why internal audits can help practices monitor reporting progress
- How practices can respond to gaps in clinician reporting
- Which types of MIPS resources support reporting review efforts
Who Should Read This
- Clinicians participating in MIPS
- Medical coders
- Quality reporting staff
- Practice administrators
- Compliance and revenue cycle teams
Codes Discussed
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