PQRS is alive and well, and ADS can help you solve its mystery!
What is PQRS?
The Physician Quality Reporting System gathers data submitted by practices to help CMS determine patient outcomes. It is practice-based, compiled for all physicians at the practice.
Isn’t PQRS the same as PQRI?
The program’s original name was PQRI (Initiative) when it began a few years ago. The name was changed to PQRS when incentives and penalties were made part of it. More on that follows below.
At the time, submitting data to PRQI was voluntary. Isn’t submitting data to PQRS today still voluntary?
Yes…there was no obligation to submit PQRI data, and the same is true today for PQRS. It is not mandatory.
If submitting my PQRS data is not mandatory, why would we want to do so?
You’d want to submit your practice’s 2014 PQRS data for two reasons:
- To obtain an extra 0.5% incentive on 2016’s Medicare reimbursements, and at the same time,
- Avoid a 2.0% penalty against the practice’s 2016’s Medicare reimbursements.
What about 2015’s Medicare reimbursements?
If you didn’t submit your PRQS data in calendar year 2013, then 2015 Medicare reimbursements will be penalized by 1.5% and you will have missed your 0.5% incentive. It’s too late to correct that now, but it’s not too late to avoid the same thing in 2016.
By the way, it’s not exactly the same thing…it’s worse. The penalty against 2016’s Medicare reimbursements is 2.0% as stated above for not reporting PQRS data in 2014...up from 1.5% against 2015’s reimbursements for not reporting in 2013.
Is it very complicated to submit our practice’s PQRS data?
Not at all. In fact, it couldn’t be easier with MedicsPremier from ADS. Using the system’s built-in “explosion code” feature, MedicsPremier automatically includes the all-important Quality Data Codes (QDCs) as regular CPT codes are entered. The QDCs become part of the overall claim submission, fulfilling CMS requirements for PQRS reporting.
Easily-obtained incentives and easily-avoidable penalties? MedicsPremier can help with both!
