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Centers for Medicare & Medicaid Services ,[object Object],[object Object],[object Object]
Disclaimers ,[object Object],[object Object]
Disclaimers ,[object Object],[object Object]
Overview ,[object Object],[object Object],[object Object],[object Object],[object Object]
Value-Based Purchasing and PQRI ,[object Object],[object Object],[object Object],[object Object]
Value-Based Purchasing Support ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
VBP Demonstrations and Pilots ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Quality and PQRI ,[object Object],[object Object],[object Object],[object Object],[object Object]
Quality and PQRI ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Benefits of PQRI Participation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI Eligible Professionals ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI Quality Measures ,[object Object],[object Object]
PQRI Form and Manner of Reporting ,[object Object],[object Object]
PQRI Determination of  Satisfactory Reporting ,[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI Bonus Payment Calculation ,[object Object],[object Object],[object Object],[object Object]
PQRI Bonus Payment Calculation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI Validation and Appeals ,[object Object],[object Object],[object Object],[object Object]
PQRI  Preparation  Strategies ,[object Object],[object Object],[object Object],[object Object]
PQRI  Preparation  Strategies:  1. Select Measures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI  Preparation  Strategies: 2. Define Team Roles   ,[object Object],[object Object],[object Object]
PQRI  Preparation  Strategies   3. Modify Workflows and Billing Systems   ,[object Object],[object Object],[object Object],[object Object]
Successful Quality Data Reporting Visit Documented in the Medical Record Encounter Form Coding & Billing Carrier/MAC Analysis Contractor National Claims History File Bonus Payment Confidential Report NCH
PQRI  Participation  Strategies ,[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 1. Reporting Quality Data ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 1. Reporting Quality Data ,[object Object],[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 1. Reporting Quality Data ,[object Object],[object Object],[object Object],[object Object],[object Object]
Successful Reporting Scenario ,[object Object],Mr. Jones presents for office visit with Dr. Thomas Mr. Jones has diagnosis of CAD Situation 1:   Dr. Thomas documents that Mr. Jones is receiving antiplatelet therapy. CPT II code 4011F* Situation 2:  Dr. Thomas documents that antiplatelet therapy is contraindicated for Mr. Jones because he has a bleeding disorder.   CPT II code 4011F-1P modifier Situation 3:   There is no documentation that Dr. Thomas or other eligible professional addressed antiplatelet therapy for Mr. Jones. CPT II code 4011F-8P modifier 26
PQRI  Participation  Strategies: 2. Understanding Satisfactory Reporting Analysis ,[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 2. Understanding Satisfactory Reporting Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 2. Understanding Satisfactory Reporting Analysis ,[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 3. Understanding Bonus Payment Calculation ,[object Object],[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 3. Understanding Bonus Payment Calculation ,[object Object],[object Object],[object Object],[object Object]
PQRI  Participation  Strategies: 3. Understanding Bonus Payment Calculation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Successful Quality Data Reporting Visit Documented in the Medical Record Encounter Form Coding & Billing Carrier/MAC Analysis Contractor National Claims History File Bonus Payment Confidential Report NCH
PQRI Feedback Reports ,[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI 2008 Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PQRI 2008 Considerations ,[object Object],[object Object],[object Object],[object Object]
PQRI Outreach & Education ,[object Object],[object Object],[object Object],[object Object],[object Object]
Most Frequently Asked  PQRI Questions & Answers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Most Frequently Asked  PQRI Questions & Answers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Most Frequently Asked  PQRI Questions & Answers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Most Frequently Asked  PQRI Questions & Answers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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PQRI Reporting

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  • 23. Successful Quality Data Reporting Visit Documented in the Medical Record Encounter Form Coding & Billing Carrier/MAC Analysis Contractor National Claims History File Bonus Payment Confidential Report NCH
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  • 35. Successful Quality Data Reporting Visit Documented in the Medical Record Encounter Form Coding & Billing Carrier/MAC Analysis Contractor National Claims History File Bonus Payment Confidential Report NCH
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