Kareo's Regulatory SME and Sr. Training Specialist, Marina Verdara, will walk you through the ABC’s of regulatory programs so you can easily meet your compliance goals and start earning more money for your practice. She will: -Provide an overview of MACRA -Breakdown the four MIPS reporting categories, including requirements for each and how you can meet them -Walk billers and billing companies through the claims submission process -Share five easy steps to help you earn up to a 9% positive payment adjustment

1. Marina Verdara
Regulatory Subject Matter Expert & Sr. Training Specialist
5 Easy Steps to Earning Money
Through MACRA

2. Safe
Harbor
The information in this presentation is confidential and proprietary to Kareo® and may not
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develop or release any functionality mentioned therein.
This document, or any related presentation and Kareo’s strategy and possible future
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or functionality. This document is for informational purposes and may not be incorporated into
a contract. Kareo assumes no responsibility for errors or omissions in this document.

3. • Welcome & Introductions
• MACRA Overview
• Claims Submission Process
• 5 Easy Steps to Meet MIPS
• How Kareo Can Help
• Your Questions

4. linkedin.com/company/kareo
Twitter
Facebook
LinkedIn
facebook.com/GoKareo
twitter.com@GoKareo

5. Supporting Your Professional Development
• PAHCOM has approved 1 CEU credit
• You’ll be asked at the end of the webinar if you
want a CEU certificate
• Certificates will be emailed within the next few
days
• Attendees must be logged into the webinar to
receive credit
• AAPC has approved 1 CEU credit
• If you would like a certificate, please email
webinars@kareo.com
• Certificates will be emailed within the next few
days
• Attendees must be logged into the live webinar
to receive credit
*This program has the prior approval of AAPC for 1 continuing
education hour. Granting of prior approval in no way constitutes
endorsement by AAPC of the program content or the program
sponsor.

6. Marina Verdara
Regulatory Subject Matter Expert & Sr. Training Specialist
• 10+ years experience working with hundreds of small practice clinicians
• Specialize in CMS Incentive Programs
• Currently provide training to help clinicians understand the Quality
Payment Program and maximize the user of Kareo Clinical EHR to meet
the requirements for MIPS

7. MACRA Overview
The Quality Payment Program

8. The Quality Payment Program (QPP)
The Quality Payment Program has helped
clinicians receive better Medicare payment rates
as it ended the Sustainable Growth Rate (SGR).
It can also help clinicians earn incentive dollars
when they participate in one of the two tracks in
the QPP.
QPP
MIPS APMs

9. The Two Tracks
• Quality
• Promoting Interoperability
• Improvement Activities
• Cost
• Accountable Care
Organizations (ACOs)
• Specialty-Specific Programs
• State-Specific Programs
Merit-Based Incentive
Payment System
Alternative Payment Models
MIPS APMs

10. MIPS: Important Facts
• Bill over $90K in Medicare Part B charges per year
• Have more than 200 Medicare Part B patients
• Render 200 or more covered professional services to
those patients
Eligibility Criteria
• Quality - 40%
• Promoting Interoperability - 25%
• Improvement Activities - 15%
• Cost - 10%
The Four Categories
• Can range between -9% to +9%
The Payment Adjustments

11. MIPS: Important Facts
• The minimum performance threshold is 60 Points
• The exceptional performance threshold is 85 points
The Thresholds
• Submit as an individual, or as a group
• Quality requires full year submission
• Promoting Interoperability = 90 days up to a full year
• Improvement Activities = 90 days up to a full year
• Cost = Full year evaluation of your Medicare Part B
claims
The Submission Options

12. MIPS: Important Facts
• Check eligibility
• Participate in training
• Collect data
• Submit data
• Receive payment adjustment
The Process

13. APMs: Important Facts
• Medicare incentive programs
• Managed by local hospitals, medical groups, IPAs
• Most are known Accountable Care Organizations
(ACOs)
• Administrator assigns quality measures to clinicians
• Clinicians may or may not be required to submit
data for MIPS
• Each APM has its own requirements and thresholds
• Providers can earn more incentive dollars than in
traditional MIPS

14. Claims Submission Process
Submit Quality Measures via Claims

15. Claims Submission Process
• Go to QPP.CMS.gov
• From MIPS, select ‘Quality Requirements’
• Scroll down & click on ‘Explore Measures’
• Scroll down to the filters & select:
• Your specialty
• Medicare Part B claims measures

16. Claims Submission Process
• Select your Quality measures from the list
• Find ‘Collection Type and Documentation’
• Select ‘Medicare Part B Claims measures
Specifications (PDF)’
• View the measure specifications that will
open in PDF format

17. Claims Submission Process
• Review the description and instructions
• Understand how the denominator is calculated
• Find the required codes under the numerator section
• Submit via Claims as they apply to your patients
• Ensure quality measures are submitted for the full year

18. 5 Easy Steps to Meet MIPS

19. 5 Easy Steps to Meet MIPS
Now that you know the basics, let’s break down the
steps. It’s important to understand that meeting MIPS
requirements is a practice effort that nowadays
includes the biller.
1. Confirm your eligibility
2. Learn the program
3. Track your progress
4. Gather all supporting documentation
5. Attest

20. Step 1: Confirm Your Eligibility
• Are you eligible?
• MIPS
• APM
• Both
• What is your goal?
• Avoid a negative payment adjustment = 60 points
• Earn a positive payment adjustment = 85 points
• Create a team:
• Provider
• Clinical Assistant
• Office Manager
• Biller

21. Step 2: Learn the Program
Prepare Your Team Kareo University Support
• Select measures and set goals
• Share responsibilities
• Determine who will make sure the team
gets trained
• Set recurring reminders to run your
reports
• Find the MACRA/MIPS course in Kareo
University
• Complete all four sessions
• Live
• Recorded
• Attend attestation webinars
• https://helpme.kareo.com/CMS_Incent
ive_Programs
• Step-by-step guides
• Short videos

22. Step 3: Track Your Progress
• Run the Quality Measures report.
• Run the Promoting Interoperability report.
• Identify measures that need improvement and review the guides for each.
• Are your scores aligned with your goals?
• Repeat every two weeks.

23. Start by Creating a MIPS Audit Folder
• Hard copy folder saved in the practice
• Electronic version
Save this:
1. Security risk assessment
2. Supporting documentation for your selected
improvement activities
3. Copies of all final reports:
• Quality Measures report in QRDA/xml format
• Promoting Interoperability in PDF format
4. Kareo certification ID number
Step 4: Gather All Supporting
Documentation

24. Step 5: Attest
• Participate in a free attestation webinar:
• Provided from Mid-January to end of March
every year
• Have your EIDM/HARP login credentials for the
QPP.CMS.Gov website
• Have your MIPS audit binder accessible
• Log into the attestation website and submit your
MIPS data for 2021
• See your preliminary score
• Final score will be provided after the attestation
deadline

25. Readiness Checklist
 Confirm clinician eligibility and determine their QPP track: MIPS or APM or both.
 Create a MIPS 2021 Audit Binder. Save an electronic version and a hard copy for every attestation
year.
 Participate in all MACRA related training sessions
 The Basics
 Quality
 Promoting Interoperability
 Improvement Activities & Cost
 MIPS Attestation Webinars (provided every year between January and March)
 Perform a Security Risk Analysis or do a reevaluation of your existing security risk analysis.
 Setup the Patient Portal
 Register with your state to begin the process for Immunization Registry Submission (if applicable)
and Syndromic Surveillance (if applicable), then open a support case with Kareo to complete the
interface setup. FAQ.
 Register with UpDox for Direct Messaging (required to Send/Receive and Incorporate summaries of
care). A clinician should register first, then other staff members can create a username.
 Run your reports for the Quality and Promoting Interoperability measures in your Kareo Clinical
every two weeks.
 Create a HARP account to submit your attestation.
 Submit your data to CMS during the submission period Jan 1 to March 31, 2022.
Kareo is here to help by providing:
• Support to both providers and billing
companies
• Free training (live and recorded)
• Step-by-step guides
• One-on-one support via our professional
services
• Free attestation webinar
• Kareo University

26. “If you fail to plan, you are
planning to fail.”
Benjamin Franklin

27. Awards and Rankings

30. Questions
Answers
For more MACRA resources and information, click here.

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