Author Topic: PQRS  (Read 3864 times)

Christy

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PQRS
« on: March 13, 2014, 01:14:30 PM »
how come we never discuss PQRS on this forum? are people reporting it? A search here only came up with 3 threads on the topic.

looking for opinions, is this a documentation issue or a billing issue? I feel that the responsibility for PQRS lies squarely on the shoulders of the provider. Some think it's a billing issue, because it's usually reported on claims and associated with reimbursement cuts. But how on earth can an outside biller/practice manager without EMR keep track of PQRS codes being reported on claims? The system is so complicated and each measure has it's own frequency reporting, etc.

I am certainly able to report the codes given by the provider on claims, but I don't feel that I could keep up with reviewing them for accuracy, etc...Yes, I know that only coders and providers do the coding, but billers are usually responsible for eyeballing codes if they notice any blatant errors...

what are others doing? also none of my providers ever heard of PQRS until I told them about it. Why doesn't Medicare send them information about it?!?!?

Merry

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Re: PQRS
« Reply #1 on: March 13, 2014, 04:36:23 PM »
Good point Christy

Medicare does send out information about PQRS if the providers are signed up for the newsletters and notices. And they have to read them in order to learn about the changes. :)
I agree with you..the biller should not be responsible for these codes at all.
All part of a claim which is a legal document.

PMRNC

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Re: PQRS
« Reply #2 on: March 13, 2014, 04:54:14 PM »
Medicare sends out tons of information on this.. if you have a client telling you they are not getting them, one has to believe they are just not reading them.
I agree with Merry, I do not believe billers should be responsible for this at all. Just like coding, however I think we should just familiarize ourselves enough to educate providers so they can turn to the appropriate professional if needed. :)   We've maintained a PQRS area within our subscriber area for a while now.
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blnord

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Re: PQRS
« Reply #3 on: March 13, 2014, 10:05:11 PM »
I bill PT and when I brought up PQRS with my providers none of them knew anything about it and none of them wish to participate, they all feel like there is way too much paperwork as it is and don't want yet another thing to keep track of, sadly they would rather take the cut in reimbursement.
I also find it frustrating when I was doing my research on CMS' website how convoluted and intimidating it was to even figure out where to start.  I definitely would love to hear from others on there experience.

Merry

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Re: PQRS
« Reply #4 on: March 13, 2014, 10:32:10 PM »
Do your providers bill Medicare? It really isn't that difficult.  A learning curve for sure but that is part of business.

blnord

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Re: PQRS
« Reply #5 on: March 13, 2014, 10:38:55 PM »
Merry, Yes we actually have quite a bit of Medicare.  Like I said I've tried to get them onboard but they just see it as one more thing they have to do.  I guess if I understood it better and knew where to start I could probably sell them on it.

Merry

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Re: PQRS
« Reply #6 on: March 14, 2014, 12:13:44 AM »
They are doing functional reporting for Medicare so they are probably overwhelmed with the changes recently for therapy.  But they need to realize that as of today the rules are that there will be penalties rather than the bonus for PQRS reporting.  Obviously their decision.  Apta.org has info on their site.


blnord

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Re: PQRS
« Reply #7 on: March 14, 2014, 08:10:21 AM »
Yes, they are aware, they say they would rather take the 2% penalty than jump through more hoops.... :(

PMRNC

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Re: PQRS
« Reply #8 on: March 14, 2014, 02:11:49 PM »
Quote
Yes, they are aware, they say they would rather take the 2% penalty than jump through more hoops.... :(

What hoops? I'm confused myself. I'm looking over the basics that we have in our subscdriber area, and it really doesn't seem so difficult to me. In fact, I'd have to question providers NOT willing to do something so simple to receive the additional revenue.  I think that although us billers don't get involved in this stuff, we CAN educate our providers as this is a part of the practice management, we need to educate them to make the right choices and go forward with things like this to receive "maximum" reimbursement.   
Linda Walker
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blnord

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Re: PQRS
« Reply #9 on: March 14, 2014, 02:23:10 PM »
Linda where in the subscribers area is the information on PQRS, I don't see it?  I think that my providers feel like the functional limitation reporting is such a pain they don't want to do one more thing.  I have tried and will continue to try but as time goes on it is a moot point.

PMRNC

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Re: PQRS
« Reply #10 on: March 14, 2014, 03:13:49 PM »
Go to the Medicare page, then scroll down and look for "Physician Quality Reporting System (PQRS) "
Linda Walker
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Merry

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Re: PQRS
« Reply #11 on: March 14, 2014, 09:17:07 PM »
But you have to do the functional reporting for therapy or the claims will get denied to Medicare. As far as the 2%, I can almost guarantee that this % will increase. I say teach them now and help them increase their revenue stream or at least not get dinged.
CMS has so much info and if you go to the APTA site and your providers are members there is a wealth of information on there.

Michele

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Re: PQRS
« Reply #12 on: March 17, 2014, 03:32:21 PM »
Even though it is not our responsibility we are educating our providers.  I agree, the CMS site tries to make it but it's harder to read than a DVD manual!
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blnord

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Re: PQRS
« Reply #13 on: March 18, 2014, 09:36:26 PM »
I definitely would like to get my providers on board, if there is anyone who does PT billing and is currently doing PQRS that I can talk to and get some clarification so that I can pass it on to them I would really really appreciate it?

Billing2

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Re: PQRS
« Reply #14 on: March 19, 2014, 12:07:41 PM »
PQRS is very easy for the providers to do. Most of them don't understand it and think there is a lot of paper work. The funny part is most of the providers already do PQRS and don't know they do it.  I would be more than happy to talk with you on the PQRS and how I explained it to my providers.