Your revenue stream is dependent on several factors. Among them are the quality of your medical coding, billing and collections, your participation in the Physician Quality Reporting System (PQRS) and understanding just how your medical practice coding, billing and collections can reveal your true revenue potential.
PQRS
Incomplete information is the culprit often times when it comes to getting all the revenue you’re due. With regard to the Physician Quality Reporting System (PQRS), incomplete quality reporting can lead to future penalties, starting in 2015, and reduced payments to physicians.
Did you know physicians could lose up to a total of $1.3 billion a year from their Medicare pay by not meeting PQRS requirements, as researched by The American College of Radiology’s Harvey L. Neiman Health Policy Institute in Reston, Va., published its study about PQRS and future penalties on Dec. 28, 2012. The study focused on participation in PQRS by radiologists, but the authors also projected the impact of program penalties on all physicians.
While participation in PQRS is voluntary, it is directly tied to penalties for non-participation starting in 2015 that results in reduced CMS payments.
If realized, this number would reflect hundreds of thousands of physicians and other health professionals not participating in, or not meeting criteria for, the Medicare physician quality reporting system. Medicare payments will be cut 1.5% in 2015 — and 2% in 2016 and beyond — for every eligible physician who fails to meet PQRS requirements by sending quality data to the Centers for Medicare & Medicaid Services. The 2015 penalty will be based on 2013 reporting activity.
NOTE: A physician or group of physicians that attempts to report PQRS measures in 2013 but does not meet the criteria for a bonus still will not have pay rates downgraded in 2015. CMS adopted this policy because 2013 is the first reporting year that involves a possible penalty. At some point, physicians will need to meet the minimum reporting criteria to stop future penalties, but it’s unknown when that change would occur.
MedRev Index
Then there’s the new information that’s uncovered about your revenue potential through a unique product in the industry called the MedRev Index.
The MedRev Index is a new dashboard tool that serves as a critical benchmark for medical practices today. This unique metric benchmarks individual medical practice revenue performance against industry averages, revealing key optimization metrics. Designed especially to meet the revenue growth goals of today’s physician practices, the MedRev Index is a meta average for your specific practice and discipline that uses a formula and produces an index actionable number. Customized according to your specialty and practice size, this algorithm-driven index serves as a benchmark, driving revenue optimization beginning with a revenue performance comparison with others in your specialty.
Doctors are then connected to an entire cadre of support to increase their bottom line on average 19 percent in most cases and:
- Further demonstrates full revenue cycle practice potential
- Develops a revenue cycle management plan for success
- Empowers practices to ensure they achieve it
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Once your MedRev Index is determined, there are other key metrics that help to ensure peak performance.
Serving medical practices throughout the U.S., Scottsdale based revMD.com is experiencing record growth in the delivery of healthcare revenue cycle management services nationwide. revMD.com optimizes practice revenues and assures compliance for hospital and community based physicians. The firm is garnering attention industry wide with its continued acquisitions, setting new industry standards with services such as the MedRev Index.
Now is no time to wonder if your medical practice billing and coding team has everything it takes to withstand the weight of PQRS changes. Outsourcing your physician revenue cycle management with experts in this field is an important next step, along with discovering your MedRev Index.
revMD.com is the results-proven alternative for medical practice billing, with a niche specialization in medical practice billing and coding that generates unprecedented results and builds profitable medical practices. Leveraging a history of industry wide success spanning 25 years, revMD.com partners with medical practices throughout the U.S. to optimize revenue for hospital based and practice based physicians. For more information, visit www.revmd.com.