ED Coding & Reimbursement Alert - 2013 Issue 38
Physician Notes: CMS Wants to Help You Benefit From PQRS
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Article Overview
This article summarizes CMS guidance for providers interested in participating in the Physician Quality Reporting System (PQRS) and explains a separate CMS update about a Supplemental Medical Review/Specialty Contractor involved in Medicare medical review activity. It is relevant to physicians, eligible professionals, billing staff, compliance teams, and anyone tracking Medicare quality-reporting participation or audit oversight trends. The piece covers general program participation steps, reporting options, and the broader purpose and scope of SMRC claim review activity.
Why This Topic Matters
It helps readers quickly determine whether they need to pay attention to CMS quality-reporting participation requirements and to the expanding network of Medicare review and audit contractors that may affect claims and documentation workflows.
What You Will Learn
- The general purpose of CMS’s PQRS participation guidance
- The broad reporting options associated with PQRS participation
- How CMS describes the role of a Supplemental Medical Review/Specialty Contractor
- The types of Medicare claim review activities discussed in the update
- Which organizations and review programs are mentioned in connection with Medicare oversight
Who Should Read This
- Physicians
- Eligible professionals
- Medical billing staff
- Compliance staff
- Practice managers
- Healthcare administrators
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