Physician Quality Reporting System: Certified PQRS Registery Service
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PQRS – Ingenious Med’s Certified PQRS Registry Service

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INGENIOUS MED’s CERTIFIED PQRS REGISTRY SERVICE

What success has Ingenious Med’s PQRS registry service had?

100% of groups using IM’s 2010-2012 PQRS registry service qualified for reimbursement checks. Over $1 million in combined reimbursements are expected for 2010 registry participants (while only a small percentage of clients took advantage of the registry service!) Groups that had never qualified a single provider after years of filing claims-based data had 100% provider success (i.e., getting checks for the first time since they began participation in 2007). Groups that had struggled to reach 50% success rates jumped to over 90% success rates (i.e., getting bigger returns than ever before).

Is there a fee for using the Ingenious Med registry service?

No. The certified PQRS registry service is available to Ingenious Med clients at no additional charge.

What are the requirements for a group to submit through IM’s registry?

• The group must have been billing within Ingenious Med applications (impower or IM1) as of 1/1 for the PQRS participation period of interest (we need to evaluate the entire participation period to determine success/failure).

o An individual provider joining a group after the 1/1 start date can still submit participation data through the registry as long as they have no bills submitted for payment under that group’s Tax ID from earlier in the same year.
o As long as they are using IM applications to capture their charges as of 1/1 of the participation period, the group may still opt into the registry service even if they turned on the PQRS module after the reporting period has begun (at which point, the start date for data capture may affect their likelihood of successful participation for the reporting period).

• Providers must usually capture all of their charges with Ingenious Med. We cannot submit for providers who bill partially in our system and partially through another system, unless all billing done outside of IM1 or impower is done under a different tax ID from the billing done within the application.
• Providers must be submitting their bills to CMS under their individual NPIs (not under a group NPI).

Can we submit some measures through IM’s registry and some measures through another registry?

There is no rule against using two separate registries to submit the same participation data, but reporting and performance data submitted by separate registries will not be combined to reflect an overall participation picture. The data submitted through each registry would be evaluated separately, and the data source reflecting most positively on the provider’s participation would be used by CMS to categorize participation success. It is important to remember that reporting events by the same provider billed under different tax IDs are considered separate participation events, and different registries could report the participation events under different tax IDs without any deleterious effects on the success of the provider under the separate tax IDs.

What is the deadline for PQRS to be activated in order to report through the registry?

There is no actual deadline for turning on PQRS in order to file through the registry. As long as providers are capturing bills in Ingenious Med applications by 1/1 of the reporting period, they could use the registry at the end of the year (opting in at any point during the year is allowed, but there are advantages to opting in earlier). As far as actually activating PQRS and collecting performance data, that becomes a game of percentages, regardless of whether they use the registry or rely on claims-based reporting. The longer they wait into the year to activate PQRS, the more reporting opportunities they miss as they see patients prior to PQRS activation. At some point in the year, they will miss so many reporting opportunities that they can’t possibly succeed for the year, but that (in and of itself) doesn’t preclude our submission of their data through the registry (we’d just submit data that says they missed a lot of reporting opportunities and didn’t do very well). Also, after a certain percentage of missed reporting opportunities for the year, since the registry success requirements are 80% x 3 measures versus the claims-based requirements of 50% x3 measures, the registry wouldn’t be very likely to increase their success rates as it would be expected to for clients who have captured PQRS data throughout the entire reporting period.

What changes appear in the system when the registry service is activated?

  • PQRS answers can be edited until data is locked down at the end of the reporting period.
  • An NPI field appears for administrators to enter those values for their users.
  • A tax ID field appears on the site/team editor for admins to enter those values for their sites.
  • When activated by Ingenious Med (at the end of the participation period), a Medicare patient identification portal becomes active for administrators.
  • An individual permission pop-up will appear for each provider on the next login.

Why is there a permission pop-up for each individual provider?

CMS requires that registries secure permission from each NPI owner before submitting their participation data through the registry service. Even providers who have signed billing agreements with their management company must give their individual approval to have their PQRS participation data included in the registry submission. Practice administrators cannot give a blanket approval for providers within their organization.

What happens if a provider answers “no” or doesn’t provide an answer for the registry permission pop-up?

Physicians without an affirmative answer on file with Ingenious Med will not have their data included in their group’s registry submission. This would not affect their flow of claims-based reporting data, and it does not affect the inclusion of other providers within the group who have given IM permission to include their data in the registry submission. If a provider says “no,” and wishes to change their answer, the flag can be reset by Ingenious Med technical support, allowing the provider to see the pop-up again on their next login. Ingenious Med technical support personnel can only reset the flag so the provider can answer again; they cannot set the provider’s answer to “yes” directly. Administrators should take care to alert all providers to the impending appearance of the permission pop-up and explain that they should answer “yes” prior to the activation of the registry service in order to minimize confusion and the necessity for answer resets.

How do clients opt into the registry service?

• Simply contact IM technical support or your account manager and request to activate the registry service.
• Alert your providers that the permission pop-up will appear upon login and explain why they should respond “yes” to the question.
• At any point between activating the registry service and the end of the participation period:

o Enter NPIs for each physician through the Edit Users tool.
o Enter tax IDs for each site through the site/team editor.
o Encourage your physicians to enter valid email addresses into the system.

• In the January following the participation period, upload a file with Medicare patient identifiers.
• Each of these elements (permissions from the providers, provider NPIs, Site Tax IDs, and Medicare patient identification file) must be in place in order to include your providers’ data in the registry submission files IM sends to CMS. The provider email addresses are optional, but will enable CMS to send individual participation feedback reports directly to the providers who provide their email.

 

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