tci Medicare Compliance & Reimbursement - 2007 Issue 23
PHYSICIANS: Successful Practices Offer Their Tips On Preparing For The PQRI
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Article Overview
This article discusses practical preparation for PQRI participation in physician practices, including documentation workflows, encounter forms, reference sheets, chart review processes, and software setup. It is aimed at physicians, coders, billers, and practice managers who need to understand the general types of documentation and systems updates involved in reporting quality measures. The piece also touches on how practices were organizing diagnosis and procedure reporting resources and using modifiers tied to quality-reporting exceptions.
Why This Topic Matters
PQRI participation depends not only on clinical performance but also on complete documentation and accurate reporting infrastructure. The article is relevant to practices evaluating how to adjust forms, staff workflows, and software so quality measures can be captured consistently.
Article Sections
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Preparing for PQRI in physician practices
Introduces how different practices were organizing their workflows and documentation processes for participation in the Physician Quality Reporting Initiative. It frames the article as a collection of operational preparation tips.
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Encounter forms and documentation reminders
Describes ways practices were updating encounter forms and other internal reminders to help clinicians capture quality-related information during routine visits and procedures.
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Hospital-based documentation and reference tools
Covers how hospital-based and specialty practices were obtaining supporting documentation and using internal reference materials to help staff identify relevant quality-reporting items.
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Software support and vendor coordination
Explains the role of practice software in capturing quality-reporting data and the need to confirm that systems can accept and flag the relevant reporting elements.
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Modifers used for exceptions and nonperformance
Summarizes the general need for exception-related modifiers and the challenge practices faced in documenting why a measure was not performed.
What You Will Learn
- How practices were organizing PQRI preparation efforts
- What kinds of documentation workflow changes were being made
- How internal reference tools were used to support reporting
- Why software compatibility mattered for quality reporting
- What broad categories of exception-related modifiers were discussed
Who Should Read This
- Physicians
- Medical coders
- Billers
- Practice managers
- Compliance staff
- Revenue cycle staff
Modifiers Discussed
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