The Resource Directory of Incentives for NCQA Clinical Recognition links clinicians to local financial and non-financial resources that support NCQA Recognition. The directory includes a list of public, private and multi-payer initiatives, by state, that support a variety of NCQA clinical Recognition programs including: Patient Centered Medical Home (PCMH), Patient Centered Specialty Practice (PCSP), Patient Centered Connected Care (PCCC), Diabetes Recognition Program (DRP), and Heart and Stroke Recognition Program (HSRP).
Comprehensive Primary Care Plus (CPC+) is a national advanced primary care medical home model that aims to strengthen primary care through a regionally-based multi-payer payment reform and care delivery transformation. CPC+ will include 2 primary care practice tracks with incrementally advanced care delivery requirements and payment options.
The Centers for Medicare & Medicaid Services (CMS) recognizes care management as one of the critical components of primary care that contributes to better health and care for individuals, as well as reduced spending.
MACRA (Medicare Access and CHIP Reauthorization Act of 2015) is bipartisan legislation that replaced Medicare’s flawed Sustainable Growth Rate (SGR) formula with a new approach to paying clinicians for the value and quality of care they provide. Previously, Medicare measured the value and quality of care provided by physicians and other clinicians through a patchwork of programs (PQRS, Value Based Modifier, Transparency Disclosure). Congress has now streamlined these various programs into a single framework to help clinicians transition from payments based on volume to payments based on value.
On October 1st, 2015, ICD-10 coding will go into effect nationwide.
Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at a distance.
You have a CPA, a financial planner,an insurance agent and an attorney.Why don’t you have a professional billing organization?
Healthy Kids Pediatrics, a growing 10 physician practice in East Windsor New Jersey, had outsourced their billing for years and was very happy with the relationship. Healthy Kids provided their biller with completed superbills, demographics, and insurance info via mail and their biller submitted the claims and did all of the follow up including the patient billing.
It may sound impossible, but with physician commitment to and the enforcement of billing best practices your practice can close in on 100% collections. This white paper discusses components of a physician's reimbursement, and provides practical tips to achieving a near-100% collection rate. This article also discusses other elements of maximizing the bottom line including services offered, pricing of these services and practical tips to prevent revenue loss.
It has been observed that small group practices are often reluctant to adopt the use of EMR (Electronic Medical Records) in their practices. Common misconceptions associated with the implementation of an EMR system include increased work load, complicated software, and additional cost with no financial benefits to the physician or increased staff and patient satisfaction.