tci Medicare Compliance & Reimbursement - 2007 Issue 38

PQRI: Prepare For 2008 Quality Reporting Now

Red flag: You can't resubmit botched claims just to fix PQRI problemsIf your clearinghouse was dropping your doctors' National Provider Identifiers (NPIs) off claims, then you won't receive any credit for quality measures you may have included on those claims. There's nothing you can do about that problem now, warned officials from the Centers for Medicare & Medicaid Services (CMS) on a Sept. 26 physician conference call about the Physician Quality Reporting Initiative (PQRI). You can't resubmit those claims just to add the PQRI information that got lost.And CMS can't work with the clearinghouses to fix the problem...

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