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3 EHR-based PQRS Reporting Options

June 26, 2013

3 options for ehr-based pqrs reportingMedical office personnel in charge of the billing and reporting duties for small and medium medical practices which have opted for EHR-based reporting should be aware that as of 2010 there are three choices available to the Physician Quality Reporting System (PQRS) program. According to the Centers for Medicare and Medicaid Services (CMS) website, once you have determined whether you are an Eligible Professional for the purposes of participation in the PQRS incentive program, you then need to choose a method to submit your data to the CMS.

Currently, the choices include:

For the purposes of this blog, it is assumed that you are eligible for participation in the incentive program and have chosen to utilize the Electronic Health Record option.

Option 1Submit your data directly through your EHR system

To do this, you will need to report on at least three measures for beneficiaries of Medicare Part B at an 80 percent rate of reporting to qualify for an incentive payment. Practices planning on using this method also need to refer directly to the ‘EHR Documents for Eligible Professionals’ zip file for the reporting program year for a list of available measures. Eligible professionals (EPs) who participate in the PQRS using an EHR Direct (qualified) product will need to obtain the necessary details for submission from the qualified EHR Direct vendor.

Option 2 – Extract and submit your PQRS quality measure data from your EHR to a qualified Data Submission Vendor.

The qualified Vendor in turn submits the PQRS data for measures reporting directly to CMS in the format CMS specifies on behalf of the eligible professional. In order to qualify for incentive payment, EPs who choose this method of reporting must, as with Option 1, also report a minimum of three measures for Medicare Part B beneficiaries at the 80 percent report rate.

The EP then refers to the applicable program’s year ‘EHR Documents for Eligible Professionals’ zip file which contains listings of measures that are available for reporting. If you plan to use this method you will need to reach your qualified Data Submission Vendor for complete submission information.

Option 3 – Submit your measures data using the PQRS-Medicare EHR Incentive Program Pilot

Using specific 2012 PQR EHR measures, participating EPs must submit information on three core measures. If one of more denominators is zero, the professional must then report up to three alternative core measures. EPs must also report on an additional three of the available measures for the Medicare EHR Incentive Program. EPs should refer to the CMS’s 2012 Physician Quality Reporting System-Medicare EHR Incentive Pilot Quick-Reference Guide, which contains listings of core, alternate core and additional available reporting measures.

As a national leader in full-service medical billing and documentation, M-Scribe Technologies has assisted practices and clinics around the country. Utilizing their expertise can help your practice meet the EHR reporting and other criteria to ensure compliance and improve your chances of receiving PQRS incentive payment regardless of size or which reporting method you choose.


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