Medicare Compliance & Reimbursement - 2007 Issue 32
PQRI: Red Flag--You Can't Resubmit Botched Claims Just To Fix PQRI Problems
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Article Overview
This premium article reviews CMS guidance from a PQRI conference call and related CMS FAQs aimed at physicians, billing staff, and coding professionals. It focuses on common reporting and claim-processing issues, broader preparation for the 2008 quality reporting cycle, and general reminders about how PQRI-related information should be handled on claims. The piece is useful for readers trying to understand CMS expectations, the impact of clearinghouse problems, and the kinds of questions raised during early PQRI implementation.
Why This Topic Matters
PQRI participation depended on accurate claim reporting, and this article explains practical issues that could affect whether quality reporting credit is received. It helps billing and coding teams recognize workflow and claims-processing concerns that may influence compliance and reporting success.
What You Will Learn
- How CMS addressed claim submission problems affecting quality reporting credit
- What general issues were discussed on a PQRI conference call
- How CMS framed preparation for the upcoming 2008 quality reporting cycle
- What broad reminders CMS provided about claim handling and related reporting practices
Who Should Read This
- Physician practices
- Medical billers
- Medical coders
- Revenue cycle staff
- Compliance teams
- Specialty societies
Modifiers Discussed
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