Are You Prepared for the 2022 QPP MIPS Reporting Period?

                                      

So, after preparing for the MIPS for the whole year, it’s time for the results. And who doesn’t want to get good results?

Have you submitted your MIPS 2022 data as per CMS requirements? The deadline for data reporting is March 31, 2023.

If No? Then all you have to do is contact QPP MIPS.

It's time to receive a positive payment adjustment or maybe the chance for an exceptional performance bonus.

We are here to take care of all your MIPS reporting needs. Just focus on your patients the most. The rest will be on us!

Call us today!


Phone number: (888) 902-1035


Address: Ontario, California, Ontario, CA 91761, USA


Website:https://qppmips.com/

Do You Know Why Early Reporting Is Important? MIPS 2022 Reporting for Small Practice

  

      

Here are the points that small practices need to know about the MIPS 2022 reporting requirements and the few steps they can take to get started and prepare for the MIPS reporting.

Small Practice and MIPS Reporting

Most of the small practices consider it tougher to avoid the penalty under the Merit-Based Incentive Payment System (MIPS) in 2022. The reason is the higher minimum performance threshold and increased cost category weight. In the 2020 MIPS, almost 9% of MIPS-eligible clinicians in the small practice had received the negative payment adjustment. And this number might get higher this year. Well, some special policies are established for the small practice to ease down their reporting burden. Well, it is important to start early reporting.

What Are the QPP MIPS Reporting Requirements for Small Practices?

A small practice can be defined as having 15 or fewer clinicians that are identified by their National Provider Identifier (NPI) and the one who bill under the Tax Identification Number (TIN). This writing focuses on the reporting requirements for the small practices participating in the Traditional MIPS participating track.

What Is the MIPS 2022 MIPS eligibility?

Small practice clinicians are required to participate in the 2022 MIPS only if they are:

· Eligible to MIPS clinician type

· Before 2022 they are enrolled as Medicare Provider

· Are not a Qualifying Alternative Payment Model Participant (QP) and also;

· Exceed the low-volume threshold as an individual

Ø Bill for Physical Fee Schedule (PFS) services with Medicare Part B permitted expenditures that exceed $90,000 annually; and

Ø More than 200 Medicare beneficiaries annually with covered professional services; and

Ø More than 200 PFS-covered professional services must be rendered annually.

Two clinicians were added to the MIPS 2022 eligible clinicians

· Nurse midwives

· Clinical social workers

The clinicians can check their eligibility status by entering their NPI into the QPP MIPS Participation Status Tool.

MIPS Categories and Weights

As a fresher, there are three categories under the QPP MIPS

· Quality

· Improvement Activities (IA)

· Promoting Interoperability (PI)

· Cost

A clinical performance across the MIPS categories results in the MIPS final score of 0 to 100 points that will be then compared to the performance threshold and also an exceptional performance threshold to determine a payment adjustment. To avoid any MIPS penalties in 2024, at least 75 MIPS points (the minimum performance requirement) must be obtained in 2022. To receive an outstanding performance bonus, clinicians must score 89 points (the additional performance criterion).

For the MIPS 2022 performance year, all the small practice clinicians will have to submit the data only for the Improvement Activities and Quality categories. When applied to small practices, CMS will automatically reduce the weight of the Promoting Interoperability (PI) performance category to 0% and increase the weight of the Improvement Activities performance category to 30%.

All the clinicians are not allowed to submit the data for the Promoting Interoperability (PI) category and also, and they don’t have to submit a PI Hardship Exception Application.

How to Get Started with MIPS 2022 Reporting?

In no time, the 2022 MIPS performance year will conclude. There are steps you can do right away to kickstart your MIPS reporting and safeguard your bottom line, even though reporting may be more difficult for some clinicians this year.

MIPS Reporting Tip for Small Practices

TIP.

Verify your MIPS qualification. To find out if you must submit MIPS reports in 2022, use the QPP Participation Status Tool website and enter your unique NPI.

END NOTE

This year, it's more crucial than ever to begin your MIPS reporting early. Our MIPS experts can assist you in creating a reporting strategy that makes sense for your practice and get you going right away. You may be sure that QPP MIPS will provide you with the direction and support tools you need to maintain your MIPS reporting schedule.

How Can You Choose a MIPS Medical Billing Service?

             

Most independent practices are financially and technologically unprepared for the several challenges of implementing value-driven care. Outsourcing medical billing services can help with most of these challenges. But the condition is that you choose your medical billing company wisely.

Why Outsource Medical Billing Services?

According to Ronnie Knight, "so many companies are here to perform your medical billing and coding, but the thing is, how much do they provide? And what are the benefits of your practice? Well, he is the CCS, CPC, CRC, and AHIMA-approved ICD-10-CM/PCS trainer. Also, the director of clinical coding and risk adjustment services at RCM Health Information Management. For example, if the vendor can help the physicians improve their scores under the merit-based incentive payment system (QPP MIPS).

Can the vendor help avoid future MIPS reporting penalties? In medical billing and coding, long-term financial viability requires a strategic approach by using the vetting process that manages the medical billing companies. Physicians must be aware of the services they are receiving because not all coding vendors have the same range of options.

Improve Your Coding Skills

In an age of value-based payment reform, physicians will contact an outsourced medical billing company for their medical billing services, which can go beyond simply reviewing a chart, as stated by Knight. Vendors should be fluent in all of the Quality Payment Programs and they are also able to help out the medical practices and make the most of the EMRs to navigate the changes. 

It’s all about helping the practices to improve their medical billing and coding not just maintain their status. The good news is that the market of physician practice continues to see an increased demand for outsourced billing which puts pressure on vendors to step up their game and provide them with more value.

Find a Medical Billing Services Partner with MIPS Knowledge

According to the knight, the medical practices should need to ask the following five questions to the medical billing company before hiring them.

1. With How Many Other Practices Does the Medical Billing Company Work?

It’s really good to put this question in the QPP MIPS context. What are the sizes and specialties of these physicians? How many of these practices are participating in MIPS and what reporting mechanisms are used by them?

2. How Do the Medical Billing Companies Support Practices in Their MIPS Participation?

For Example, some companies use software to analyze the claims data and review the current documentation to help the practices to identify the most appropriate MIPS measures for the specialty and patient population. According to Knight, physicians frequently already perform the labor required to support a MIPS measure but lose out on more income because they fail to record certain information or check off specific boxes in the EMR. 

A MIPS-savvy billing partner has the resources to identify these lost opportunities and get doctors back on track by giving them continual training and feedback. Moreover, some of the vendors can create templates for the documentation that helps the physicians to capture the relevant information for the Quality Payment Programs.

3. How Does the Billing Company Stay Up-To-Date with MIPS and Other Quality Payment Programs?

How knowledgeable is the business about rules and incentive programs? Practices require a billing partner who is committed to training its employees and changing in line with the reform of quality-based payments.

4. Does the Medical Billing Company Provides the Coding "test runs"?

According to Knight, this is an opportunity to determine precisely what the practice will get for the cost. Does the business provide something fresh, she inquires? "Check to see if the vendor meets your expectations."

5. Has the Billing Company Used Electronic Health Records Before?

According to Knight, physicians are more successful under MIPS when the billing partner has a thorough understanding of the practice's EHR and can assist them in enabling various options to improve quality data reporting. This offers instruction on how to, for instance, run reports, activate reminders for preventative care, and use documentation prompts. The provider frequently is unable to use the EHR effectively, according to Knight. "Sometimes, all it takes is demonstrating how to utilize it,"

Want to Maintain In-House Billing While Receiving Help from a Billing Partner?

Even if the practice opts to continue doing its billing and coding, it must make sure that any employees they hire are capable of spotting chances for bettering the paperwork and data capture, advises Knight. She adds that external billing providers could be able to offer this training and aid practices in setting up an internal auditing program.

END NOTE

Above are the few questions mentioned by Knight that are very beneficial for you to ask the billing vendors before hiring them for your medical billing services. They can help you find the most efficient billing company that can help you a lot.

A Guide for QPP MIPS Consultants to Maximize Payment Adjustments

                         

QPP MIPS consultants play a crucial role in helping eligible clinicians navigate the QPP MIPS program and achieve the highest possible score. Read more about how to maximize performance.

The Quality Payment Program (QPP) MIPS is a performance-based payment system that measures eligible clinicians' performance in four categories: Quality, Improvement Activities, Promoting Interoperability, and Cost. For QPP MIPS consultants, understanding the QPP MIPS program's ins and outs is crucial for ensuring their clients receive the highest possible payment adjustment, especially with the introduction of QPP MIPS 2022.

Why QPP MIPS Consultants are Important?

QPP MIPS consultants play an essential role in helping eligible clinicians navigate the QPP MIPS program and maximize their payment adjustments. With the constantly evolving program requirements, these consulting services can help ensure their clients meet all of the necessary criteria and can report their performance measures accurately. By working with them, clinicians can also save time and effort in understanding the complex reporting requirements and focus on providing high-quality care to their patients.

Leveraging the QPP MIPS Reporting Service

One of the essential tools that MIPS Qualified Registries can leverage is the QPP MIPS reporting service. This service provides clinicians with the necessary resources and tools to report their performance measures accurately, including the QPP MIPS 2022 Quality Measures. By utilizing this service, clinicians can easily report their performance data for each category, ensuring they comply with the new requirements of QPP MIPS 2022. As a result, QPP MIPS consultants can help their clients accurately report their performance data, which can improve their chances of receiving a positive payment adjustment under QPP MIPS 2022.

Understanding QPP MIPS Quality Measures 2022

In terms of the Quality category, you must be familiar with the QPPMIPS Quality Measures 2022, which are used to evaluate a clinician's performance in the Quality category and are assigned a weight based on their level of importance. By understanding these measures, MIPS consultants can help their clients identify the most critical areas for improvement and develop strategies for achieving higher scores under QPP MIPS 2022. This can improve their clients' overall performance and increase their chances of receiving a positive payment adjustment under QPP MIPS 2022.

Staying Up-to-Date with MIPS Quality Measures

Another critical aspect that QPP MIPS consultants must be aware of is the MIPS Quality Measures, which are updated annually and will be used to evaluate a clinician's performance in the Quality category for QPP MIPS 2022. MIPS consultants must stay up-to-date with the latest measures to ensure their clients are reporting accurate data and complying with QPP MIPS 2022 requirements. Staying up-to-date with the MIPS Quality Measures can also ensure that MIPS consultants can help their clients improve their overall performance and maximize their payment adjustment under QPP MIPS 2022.

Conclusion

In summary, QPP MIPS consultants play a crucial role in helping eligible clinicians navigate the QPP MIPS program and achieve the highest possible score, especially with the new requirements of QPP MIPS 2022. By leveraging tools like the QPPMIPS reporting service and understanding the QPPMIPS Quality Measures 2022 and MIPS Quality Measures, MIPS consultants can help their clients accurately report their performance data and develop strategies for achieving higher scores under QPP MIPS 2022. Ultimately, this can lead to a positive payment adjustment for their clients and help drive quality care in the healthcare industry. By working with QPP MIPS consultants, clinicians can focus on providing high-quality care while maximizing their payment adjustments under the QPP MIPS program.

MSSP ACO Reporting Options in 2022

                                                                 

EHR submissions for all eCQMs and registry submissions for MIPS CQMs are the only two quality options open for ACO reporting in 2022.

QPP MIPS has already informed MSSP ACOs about the alarming signs for ACO reporting in 2022. For a successful transition from MIPS to MVPs, PY 2022 and 2023 are significant years for QPP. Thus, CMS has provided Medicare ACO with regulations for ACO reporting in PY 2022. Moving back to PY 2021, CMS has considered CAHPS for ACOs Survey measure as a separate measure. However, CMS has finalized a new initiative from the PY 2022 ACO reporting. Thus, ACOs have to report the APP measure set with two allowed reporting options only. The two reporting options for ACO performance quality data submission are given as follows:
EHR-based quality submissions
Qualified Registry-based Submissions

Let’s find out new ways coming our way with ACO quality reporting options in 2022!

APP Measure Set Framework for PY 2022

Meanwhile, CMS has modified the specification for the APP measure set as well. Now, each APP measure set will have a constitutional framework of the following:
Three Clinical Quality measures
The CAHPS for MIPS Survey measures (as one measure)
Two Administrative Claims measures

Comparing APP Measure Set Construct with the PY 2021 Set

•  There was CAHPS for ACO Survey measures in place of CAHPS for MIPS Survey measures in the 2021 measure set.

•  Since CMS has secure readmission measures for MIPS, therefore readmission measures for accessing ACOs are different. The readmission measures are concerned with activities under a period of 30 days when a patient discharges from the hospital.

•  Sometimes, the patients receive their medical services at home due to their chronic conditions. Thus, CMS is working on new ‘Days at home’ measures for ACO reporting in the coming years.

•  Moreover, CMS has issued the ‘All-patients reporting’ criteria for quality reporting. Customarily, the ACOs had to report only a selected group of patients. However, CMS now requires reporting at least 70 percent of patients that fulfills the measure criteria. This significant change seems a unique approach in ACO reporting 2022.

There is a little confusion about all-patient reporting among ACOs. What if these patients have different payers? In other words, the patients might come with an insurance plan from different insurance companies. So if such patients fall under the measure criteria, then what should ACO do?

Well, CMS has forwarded one simple solution for this specific case. ACOs can still report such patients regardless of their payer types. CMS has nothing to do with the payer type. All CMS has concerns with the delivery of high-quality care episodes to every patient. And ACO reporting is another way of analyzing the finest healthcare performance of providers.

Reporting Options Available for ACO Reporting 2022

We have depicted earlier in our discussion that CMS Web Interface will no longer be available for ACO reporting. Not only for ACOs, but CMS has also expired Web interface for MIPS, APPs, and MVPs as well. Consequently, all ACO Medicare have left with two options; eCQM (EHR submission) and MIPS CQM (registry submission).

Similarly, ACOs have a direct login option for data submission via Application Program Interface. And if they do not have their API profile yet, they must sign in first and then, upload their data. Here, ACOs can trust any ACO-qualified registry that acts as a third-party intermediary in ACO reporting. The ACO QRs are aware of the API platform, they deal with submission data programmatically with their CEHRT.

Instructions for EHR Submissions

According to CMS, eCQMs are;

A clinical quality measure that evaluates the standard of healthcare. It gathers organized patient data while the patient is receiving care. Moreover, it articulates and sets up systems to utilize data from EHRs and/or other health IT.

Last but not least, according to the CMS QPP website, if an ACO switches systems during the performance year, data should be combined from the old and new EHRs into a single report for the whole 12-month period before the data are submitted. If a full year's worth of data is not accessible (for instance, if aggregation is not feasible), data completeness must account for the whole year. Both of your EHR systems must be 2015 Edition CEHRT if you are submitting eCQMs.

Conclusion

After the comprehensive details above, you will be able to portray a clear picture of ACO Reporting in 2022. The performance year 2022 has brought significant changes for ACOs as a whole. Now, they have only eCQM and MIPS CQM specifications. The CMS binds them to report on all patients as well. Alongside this, these new transitions in ACO reporting have accompanied several new challenges. Although, CMS has tried hard to clear all the concerns of ACOs. But still, ACO has some queries that NAACOS is trying to deal with efficiently. NAACOS gets in touch with CMS and gathers information from its ACO-tailored/specific education efforts. That’s how it tries to clarify the providers’ queries.

Are You Prepared to Earn MIPS Incentives 2021?

As we are approaching the end of 2021, medical practices are attempting to capture the most of their value-based services. We are talking about the MIPS 2021 program that helps clinicians achieve maximum financial independence via incentives and $500 million worth of bonuses. However, they are also looking for MIPS Qualified Registries to assist them in abiding by the tough CMS rules and policies.

MIPS Reporting Is Essential for Every Clinician 

To be honest, we are just a few months far from the reporting period. And, all eyes are on the administrative load. Physicians do not have much time to cater to reporting methods efficiently. Therefore, the better option is to consult MIPS consulting services nominated by CMS. Otherwise, there is a chance of financial disintegrate.

Why Participate in MIPS 2021?

Of course, MIPS encourages physicians to focus on their primary operations without having to worry about the data documentation.

Under QPP MIPS data submission, clinicians have a chance to prioritize quality over quantity. Moreover, another factor that this program pays heed to is to curb the increasing value expenditure in the healthcare industry.

Here is the tidbit of what this program settles for.

 MIPS data reporting encourages medical practitioners to:

     • Use technology to optimize the patient care methods (diagnosis, treatment, medication)

     • Efficiently use resources for patient treatment

     • Adopt various yet quality ways over costly procedures

These are just a few points to capture the essence of MIPS reporting. However, the successful MIPS data submission 2021 will make you earn MIPS incentives, supported through high performance instead of the number of patients. 

QPP MIPS Promotes Quality Healthcare Services

The healthcare industry’s dynamics are changing. Especially, in this technology age, the only way forward towards progression is to adopt the technology.

It is also the truth that modern clinicians have to stay true to the care standards in every matter, from resources to treatments. We have a few tips to enhance MIPS points that medical practices must implement in order to maximize their performance.

1. Implement Certified EHR Technology

Physicians cannot maximize their score in the MIPS Promoting Interoperability (PI) category without implementing 2015 Certified EHR technology.

Clinicians can compromise on anything but the certified data documentation system is inevitable. Also, you have to use the 2015 version, if not the latest one.

Investing in EHR technology is within the best interests of medical practices. It will offer further mileage to their efforts. Moreover, medical billing services can save time and energy and give room for medical practitioners to do their operations vigilantly.

2. Concentrate on MIPS Reporting Needs

There is a list of reporting requirements that each MIPS eligible medical practitioner should abide by to perform well in the quality program. For instance, amidst the Corona situation, CMS allowed relaxation in some areas. Moreover, we could also see the performance threshold has been raised.

Thus, clinicians ought to pay full attention to the reporting requirements. For that, they can consult a MIPS Qualified Registry to select acceptable specialty-specific quality measures. 

3. Outsource Administrative Load to Professionals 

We have seen several incidents wherever physicians took the responsibility of MIPS reporting on their shoulders and failed miserably.

Here the MIPS Qualified Registry can help you handle all the administrative tasks and submit data in 2021 timely.

Government policies keep changing, so as a medical practitioner, it's troublesome to get into details of each matter.

However, with a knowledgeable team at your disposal, staying up-to-date is easy. Moreover, you'll be able to ultimately earn high points in QPP MIPS reporting 2021.

Conclusion

In this article, 3 golden rules depict if a practice is prepared to thrive in MIPS. Therefore, each medical practitioner must upgrade and look for help in matters that are out of their hand. Only then they can guarantee quality standards for patients and earn high MIPS incentives in return.

Things You Need to Know About Quality Payment Programs to Flourish

Quality payment programs have changed the way physicians offer their services. The reimbursements now facilitate clinicians as per fee-for-quality rather than fee-for-service. Therefore, you need to know how you can avoid a 9% penalty in case of poor MIPS 2021 data submission to CMS (Centers for Medicare and Medicaid Services).

MIPS reporting has been a part of the US healthcare system for five years now. Years before, physicians could even pay a little attention to it, and it was enough. But now, one thing is certain; the lesser you focus on quality healthcare, the lesser points you will receive, and even will have to suffer a penalty.

What Can Physicians Do?

We can see a significant increase in Medicare patients. You have to therefore perform to the best of your abilities while implementing technology for the ease of the process. It comes with a lot of stress and anxiety. However, QPP MIPS also brings a disguised opportunity, which can help you improve your financial situation.

What Caused the Change of Reimbursement Models?

Realistically, we could see healthcare expenses have been increasing, but the compromise on quality was out of the question. The healthcare authorities thus advise clinicians to strive for quality rather than volume. These expectations have created an impact on the quality, where Medicare patients are the most crucial beneficiary.

Here are a few things that you should know to successfully complete the QPP MIPS reporting.

MACRA is Not the Replacement of the ACA Act

Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is NOT the Affordable Care Act. ACA, aka Obamacare, governs the insurers or the individuals who pay. It particularly states that healthcare coverages must meet certain standards. In an otherwise case, companies would have to bear penalties for non-compliance.

Whereas, MIPS & MACRA addresses the healthcare delivery reforms against coverage offered by the government. Sustainability and innovation are the most focused aspects of these programs. Clinicians must perform improvement activities in four major sectors, and based on the submitted data, authority rewards score. Ultimately, the score decides if the clinician is qualified for positive or negative payment adjustment.

Thus, for successful MIPS reporting, medical practices must consider what components can get them more scores in the end.

Know Your Reporting Options

Clinicians must know their reporting options in order to succeed. It is to remember that MIPS only caters to the physician's payments, namely PART B Medicare payments. So, healthcare workers have several options to get their services recognized by the authorities (MIPS, APP, ACO reporting).

Based on the medical specialty or the method of care delivery, one can choose a suitable method of data reporting. Generally, a MIPS Qualified Registry assists with successful and timely data submission as the administrative load and compliance issues are quite hectic.

Moreover, clinicians have the option to report as an individual, group, or virtual group. For group or virtual groups, participants need to assign their billing rights to a single Tax Identification Number.

Don’t Wait for the End Period to Report

Clinicians can successfully target MIPS incentives. However, they need to stop thinking and act now, otherwise, they could risk up reimbursements up to 5%. In a favorable condition, they can easily qualify for even the $500 million bonus. 

Moreover, this flexible program allows many adjustments in unfortunate circumstances.

Many things could go wrong if you are not careful. For instance, you have to report data for Improvement Activities for at least 90 days. Failed to do so, and you will not receive any point.

Conclusion

We must know that CMS rewards points and payment adjustments are based on your performance and not the amount of data submitted. So, you can be a potential winner of the program only if you consider the dynamics of Quality Payment Programs as per the CMS requirements.  MIPS consultants can also be of great help in this regard.

So clinicians! If you want to recognize in the Physicians’ Portal and receive positive payment adjustments or incentives for exceptional performance, ensure a thorough understanding of QPP to benefit your RCM.