New in Iridium Suite – Automated PQRI

3/30/2009CMS created the Physician Quality Reporting Initiative (PQRI) in 2007, which establishes a financial incentive for eligible professionals to participate in a voluntary quality-reporting program. The program was renewed in 2008 and the program is expected to be continued beyond. Physicians that qualify and properly report their PQRI data will earn an incentive payment of 1.5 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period.

3/30/2009CMS created the Physician Quality Reporting Initiative (PQRI) in 2007, which establishes a financial incentive for eligible professionals to participate in a voluntary quality-reporting program. The program was renewed in 2008 and the program is expected to be continued beyond. Physicians that qualify and properly report their PQRI data will earn an incentive payment of 1.5 percent of their total allowed charges for Physician Fee Schedule (PFS) covered professional services furnished during that same period.

Properly, is the key word. To this point providers have had a consistently difficult time successfully reporting their PQRI measures. The reporting requirements are  fairly difficult to meet because they are very time sensitive and the PQRI numerator codes need to be billed in a very specific manner which many billing systems  are not capable of. Some of these requirements include the need to be billed in conjunction with the denominator service lines that trigger the measure and the  need to bill them as zero dollar charges. Most billing software systems are not able to report PQRI charges requiring the providers to manually bill them. The billing systems that are able to report them still require a lot of work to get the codes billed properly.

To put it simply, manually billing PQRI measures correctly is very difficult to get right. In response to these difficulties, Medical Business Systems has produced an automated PQRI implementation in the Iridium Suite that simplifies PQRI billing.

For more information, call our sales team.