Invoice Management, Invoicing, Automated Invoicing,Customer management

Grow Your Annual
Revenue By 15% !!!
Reduce Your Total
Cost By 30% utilizing
our unique Hybrid
WorkFlow Model™.

Clinic Spectrum - Medical Transcription Services, Accounts Receivable Follow-ups, Scanning & Indexing, No-Show Rescheduling & Appointment Scheduling, Eligibility Verification with Payers, Referral Submission & Tracking, Payment Posting, Demographics & Claim Entry, Credentialing, NJ, New Jersey, New York, USA.
Raffle | Login
Clinicspectrm on Facebook Clinicspectrm on Twitter Clinicspectrm on YouTube Clinicspectrm on LinkedIn   LiveZilla Live Chat Software LiveZilla Live Chat Software
   
Login to My Account  or  Create Account

Physician Quality Reporting System (PQRS)

The Physician Quality Reporting System (PQRS) is a quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time. CMS has released the Physician Quality Reporting System (PQRS)specifications for the 2015 reporting period and as expected, they are full of changes.

Participation as an individual EPs who wish to report via Qualified Registry

Individual Measure

Report on at least 9 individual measures covering 3 National Quality Strategy (NQS) domains for at least 50% of the EP’s Medicare Part B FFS patients.

[An EP who sees at least 1 Medicare patient (face-to-face encounter) must report on 1 cross-cutting measure, counts towards the 9 measures.]

Group Measure

Report on at least 9 individual measures covering 3 National Quality Strategy (NQS) domains for at least 50% of the EP’s Medicare Part B FFS patients.

[An EP who sees at least 1 Medicare patient (face-to-face encounter) must report on 1 cross-cutting measure, counts towards the 9 measures.]

Participation as PQRS Group Practice (GPRO)

The Physician Quality Reporting System (PQRS) is a quality reporting program that encourages individual eligible professionals (EPs) and group practices to report information on the quality of care to Medicare. PQRS gives participating EPs and group practices the opportunity to assess the quality of care they provide to their patients, helping to ensure that patients get the right care at the right time. CMS has released the Physician Quality Reporting System (PQRS)specifications for the 2015 reporting period and as expected, they are full of changes.

Individual Measure

Report on at least 9 measures covering 3 NQS domains for at least 50% of the group’s Medicare Part B FFS patients [If 1 Medicare patient is seen face-to-face during the reporting period, the PQRS group practice must report on at least 1 cross-cutting measure].

2015 PQRS Measure-Applicability Validation (MAV) Process for Registry-Based Reporting of Individual Measures

provides guidance for those eligible professionals who satisfactorily submit via a Qualified Registry for fewer than nine PQRS measures or for fewer than three NQS domains, and how the MAV processwill determine whether they should have submitted additional measures. This also includes the process flow depicting the MAV process.

2015 Clinicspectrum Registry PQRS Individual Measures:

  • Report 9 individual measures over 3 National Quality Strategy (NQS) domains for 50% of 2015 eligible Medicare Part B Fee-For Service (FFS) patients.
  • Providers who treat at least 1 Medicare patient in a face-to-face encounter, must report on at least 1 cross-cutting PQRS measure.

Domain: Effective Clinical Care

  • Measure #1 Diabetes: Haemoglobin A1c Poor Control
  • Measure #5 Heart Failure (HF): Angiotensin-Converting Enzyme (ACE) Inhibitor or Angiotensin Receptor Blocker (ARB) Therapy for Left Ventricular Systolic Dysfunction (LVSD)
  • Measure #6 Coronary Artery Disease (CAD): Antiplatelet Therapy
  • Measure #7 Coronary Artery Disease (CAD): Beta-Blocker Therapy – Prior Myocardial Infarction (MI) or Left Ventricular Systolic Dysfunction (LVEF < 40%)
  • Measure #8 Heart Failure (HF): Beta-Blocker Therapy for Left Ventricular Systolic Dysfunction (LVSD)
  • Measure #39 Screening or Therapy for Osteoporosis for Women Aged 65 Years and Older
  • Measure #43 Coronary Artery Bypass Graft (CABG): Use of Internal Mammary Artery (IMA) in Patients with Isolated CABG Surgery
  • Measure #44 Coronary Artery Bypass Graft (CABG): Preoperative Beta-Blocker in Patients with Isolated CABG Surgery
  • Measure #48 Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older
  • Measure #51 Chronic Obstructive Pulmonary Disease (COPD): Spirometry Evaluation
  • Measure #52 Chronic Obstructive Pulmonary Disease (COPD): Inhaled Bronchodilator Therapy>
  • Measure #53 Asthma: Pharmacologic Therapy for Persistent Asthma - Ambulatory Care Setting
  • Measure #71 Breast Cancer: Hormonal Therapy for Stage IC -IIIC Estrogen Receptor/Progesterone Receptor (ER/PR) Positive Breast Cancer
  • Measure #72Colon Cancer: Chemotherapy for AJCC Stage III Colon Cancer Patients
  • Measure #91 Acute Otitis External (AOE): Topical Therapy
  • Measure #112 Breast Cancer Screening
  • Measure #113 Colorectal Cancer Screening
  • Measure #117 Diabetes: Eye Exam
  • Measure #119 Diabetes: Medical Attention for Neuropathy
  • Measure #121 Adult Kidney Disease: Laboratory Testing (Lipid Profile)
  • Measure #122 Adult Kidney Disease: Blood Pressure Management
  • Measure #163 Diabetes: Foot Exam
  • Measure #164 Coronary Artery Bypass Graft (CABG): Prolonged Intubation
  • Measure #165 Coronary Artery Bypass Graft (CABG): Deep Sternal Wound Infection Rate
  • Measure #166 Coronary Artery Bypass Graft (CABG): Stroke
  • Measure #167 Coronary Artery Bypass Graft (CABG): Postoperative Renal Failure
  • Measure #168 Coronary Artery Bypass Graft (CABG): Surgical Re-Exploration
  • Measure #205 HIV/AIDS: Sexually Transmitted Disease Screening for Chlamydia, Gonorrhea, and Syphilis
  • Measure #236 Controlling High Blood Pressure
  • Measure #242 Coronary Artery Disease (CAD): Symptom Management
  • Measure #271 Inflammatory Bowel Disease (IBD): Preventive Care: Corticosteroid Related Iatrogenic Injury – Bone Loss Assessment
  • Measure #274 Inflammatory Bowel Disease (IBD): Testing for Latent Tuberculosis (TB) Before Initiating Anti-TNF (Tumor Necrosis Factor)Therapy
  • Measure #275 Inflammatory Bowel Disease (IBD): Assessment of Hepatitis B Virus (HBV) Status Before Initiating Anti-TNF (Tumor Necrosis Factor) Therapy
  • Measure #389 Cataract Surgery: Difference Between Planned and Final Refraction

Domain: Efficiency and Cost Reduction

  • Measure #93 Acute Otitis Externa (AOE): Systemic Antimicrobial Therapy – Avoidance of Inappropriate Use
  • Measure #331 Adult Sinusitis: Antibiotic Prescribed for Acute Sinusitis (Appropriate Use)
  • Measure #332 Adult Sinusitis: Appropriate Choice of Antibiotic: Amoxicillin Prescribed for Patients with Acute Bacterial Sinusitis (Appropriate Use)
  • Measure #333 Adult Sinusitis: Computerized Tomography for Acute Sinusitis (Overuse)

Domain: Community/Population Health

  • Measure #110 Preventive Care and Screening: Influenza Immunization
  • Measure #111 Pneumonia Vaccination Status for Older Adults
  • Measure #128 Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
  • Measure #131 Pain Assessment and Follow-Up
  • Measure #134 Preventive Care and Screening: Screening for Clinical Depression and Follow-Up Plan
  • Measure #173 Preventive Care and Screening: Unhealthy Alcohol Use – Screening
  • Measure #226 Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
  • Measure #317 Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
  • Measure #402 Tobacco Use and Help with Quitting Among Adolescents

Domain: Patient Safety

  • Measure #130 Documentation of Current Medications in the Medical Record
  • Measure #154 Falls: Risk Assessment
  • Measure #192 Cataracts: Complications within 30 Days Following Cataract Surgery Requiring Additional Surgical Procedures
  • Measure #388 Cataract Surgery with Intra-Operative Complications (Unplanned Rupture of Posterior Capsule requiring unplanned vitrectomy)

Domain: Person and Caregiver-Centered Experience and Outcomes

  • Measure #143 Oncology: Medical and Radiation – Pain Intensity Quantified
  • Measure #144 Oncology: Medical and Radiation – Plan of Care for Pain

Domain: Communication and Care Coordination

  • Measure #155 Falls: Plan of Care
  • Measure #182 Functional Outcome Assessment

Domain: Person and Caregiver-Cantered Experience and Outcomes

  • Measure #303 Cataracts: Improvement in Patient’s Visual Function within 90 Days Following Cataract Surgery
  • Measure #304 Cataracts: Patient Satisfaction within 90 Days Following Cataract Surgery
  • Measure #358 Patient-centred Surgical Risk Assessment and Communication
  • Measure #390 Discussion and Shared Decision Making Surrounding Treatment Options

2015 PQRS Penalty

2015 is the first year that there is no longer an incentive payment for PQRS participation. The PQRS program now carries an automatic 2% penalty for non-participation in reporting PQRS measures by eligible solo providers and GPRO group practices.

Important 2015 PQRS Changes:

  • The penalty for not reporting 2015 PQRS is 4% for solo providers and groups with 2-9 providers (2% value modifier penalty + 2% PQRS penalty).
  • The penalty for not reporting 2015 PQRS is 6% for groups with ten or more providers(4% value modifier penalty + 2% PQRS penalty).
  • There is no incentive payment for 2015 PQRS reporting.
  • 2015 PQRS Measures Groups Specifications Manual.It include codes and reporting instructions for all PQRS measures groups available for registry-based reporting.
  • 2015 PQRS Measures Groups Release Notes– Summary of 2015 updates made to the 2014 PQRS Measures Groups Specifications.
  • 2015 PQRS Measures Group List– Identifies and describes all the measures groups used in PQRS, including measures description, corresponding PQRS number and NQF number, plus measure developers.
  • 2015 PQRS Measure Specifications Manual for Reporting of Individual Measures– Includes codes and reporting instructions for the 2015 PQRS measures for claims and/or registry-based reporting.
  • 2015 PQRS Individual Measures Specification Release Notes – Summary of 2015 changes made to the 2014 PQRS Individual Measures Specifications.
  • The value-based payment modifier applies to all physicians. The value modifier uses PQRS quality data and Medicare cost data to determine a provider's overall value score. It rewards high-performing providers with increased payments and reduces payments to low-performing providers. This will affect approximately 900,000 physicians.
  • Quality-tiring is mandatory for all providers. However, solo providers and groups with 2-9 providers will receive only a bonus or no adjustment. Groups with 10 or more providers will receive a bonus, no adjustment or a penalty.
  • CMS is requiring that eligible professionals who see at least one Medicare patient in a face-to-face encounter report measures from a newly proposed cross-cutting measures set in addition to any other measures that the eligible professional is required to report. Please reference the 2015 PQRS List of Face-To-Face Encounter Codes for the billable codes that identify face-to-face encounters for the purposes of 2015 PQRS reporting. This includes general office visits, outpatient visits, and surgical procedure codes.
 
 
Products Services
InvoiceSpectrum Account Receivable Follow-Up
CredentialingSpectrum Denials and Appeals Management
ProductivitySpectrum Scanning & Indexing
AutoCollectSpectrum No-show Rescheduling & Appointment Scheduling
SupportSpectrum Referral Submission & Tracking
HRMSpectrum Payment Posting
WorkflowSpectrum Demographics & Claim Entry
ChargeSpectrum Credentialing
mypersonalchart Medical Transcription Services
Clinicspectrum Registry Digital Content Creation
Call 908.834.1608
New Jersey
2222 Morris Ave. 2nd Floor,
Union, NJ-07083
Phone:908-834-1608

Sales
Ph: (908)-834-1608
Email:info@Clinicspectrum.com

© Copyright 2012. Clinicspectrum, All Rights Reserved.
Privacy Policy
"Clinicspectrum
is
Your
Personal
Office
Genie
Ready
to
Serve...
365
 Days !"