PQRS Update: Update Billing Software for PQRS Claims

Why This Topic Matters

It helps practices understand how PQRS-related claim processing changed for 2014 and why billing systems may need updates to support compliant reporting workflows and Medicare EOB responses.

Article Sections

1. Introduction

   Introduces the article’s focus on Medicare PQRS reporting changes and the practical impact on claims and billing workflows.

2. Details

   Summarizes the remittance and denial code changes associated with quality data reporting line items and the billing charge amounts discussed in the update.

3. What to do

   Describes the need to coordinate with billing software or EHR vendors to support updated reporting and charge processing requirements.

4. Avoid the Penalty, But Try To Get the Bonus As Well

   Reviews the broader PQRS reporting context for 2014, including incentive and penalty considerations and the general role of measure reporting validation.

5. Advice

   Provides high-level reporting guidance focused on meeting minimum PQRS reporting expectations and understanding how performance is evaluated.