PQRI
MEASURES YOU CAN DOWN LOAD, EDIT
AND USE AS ENCOUNTER FORM-
www.aafp.org/fpm/20070600/fullpqrimeasures.xls
MEDICARE PQRI PAGE- You can down load and review
the program- http://www.cms.hhs.gov/PQRI/15_MeasuresCodes.asp#TopOfPage
Copy and paste the link on your web browser
The potential PQRI bonus is
based on total allowed charges for covered professional services furnished
during the reporting period and paid under the Physician Fee Schedule.
IF YOU NEED SOMEONE TO COME TO YOUR OFFICE AND SET YOU
UP, CALL 845-621-2211 - SPEAK TO FRAN (nominal charge may apply)
FAQ
Q. Do I have to
register to participate in the PQRI?
A.No.
Simply begin submitting claims on July 1, 2007.
A.
Q. Do I need an
individual NPI to participate in the PQRI?
A.Yes.
Analysis of satisfactory reporting and the bonus payment calculation
will be done at the individual level, so your individual NPI must be used on
the claim.
A.
Q. Do I have to
agree to accept assignment on claims to participate in the PQRI?
A.No.
You must be an enrolled Medicare provider, but you need not have
signed a Medicare participation agreement to accept assignment.
Q.
Can CPT Category II quality codes be submitted separately from claims
for payment?
A.No.
Quality codes must be submitted on the same claim as the ICD-9 and
CPT Category I codes because the analysis of satisfactory reporting requires
that both the numerator and denominator codes be present.
Q Can more than one
participating professional report quality codes on the same patient?
A.Yes.
Every participating professional who furnishes services for a patient
may report according to the measure instructions.
A.
Q. If the measure instructions indicate that the measure is
properly reported once during
the reporting period, must a quality code be submitted on every claim that
contains the denominator ICD-9 and CPT codes for that patient?
A.No.
The CPT Category II numerator code need only be reported once during
the measurement period if that is what the instructions for that measure
indicate.
Q. Will my patients have to pay a share of the PQRI bonus?
A.No.
There is no beneficiary co-insurance.
Participating professionals cannot collect any payment from
beneficiaries for quality reporting.
Beneficiaries will receive a message on their Medicare Summary
Notices (MSNs) indicating that they should not be charged for the
quality data codes.
A.
Q. Will the
number of PQRI participants in our group practice affect our analysis of
satisfactory
reporting?
A.No.
The analysis of satisfactory reporting will be done at the
individual level by NPI.
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