In this webinar, Sr. Training Specialist, Marina Verdara, will provide you with the information and tools you need to ensure that your business avoids receiving penalties related to MACRA.
Marina will:
-Provide an in-depth analysis of MACRA, including APM and MIPS
-Review the four MIPS reporting categories and how your business can meet each of their individual requirements
-Recommend industry best practices so both independent medical practices and billing companies can avoid penalties in 2019
Avoid the Burnout of Owning Your Own Medical PracticeKareo
In this live webinar, Healthcare Business Consultant Aimee Heckman will:
-Identify the main causes of physician burnout, from a provider and office manager standpoint
-Provide solutions to easily implement in your daily workflow to reduce the chances of burnout
-Discuss how you can maintain a healthy balance going forward
Learn how to identify and track indicators of your company's financial health. Dave Justus, Kareo's Chief Financial Officer, and Ted Stack, founder of Falcon Capital Partners, will discuss the key performance benchmarks and insights you should pay attention to when working to optimize your billing company business.
Key Considerations When Choosing Cloud-Based SoftwareKareo
Practice Management software is a critical component of any medical billing company. As technology continues to advance, 'cloud-based’ is being touted more than ever. Join us as we take a deeper look at what a cloud-based solution can offer your business, discuss the key features and benefits of transitioning to the cloud, how to ensure that you have the support needed for a smooth transition, and the data security red flags you should be looking out for.
2019-05 Maximize Your Revenue with 3 Key Medical Billing KPIsKareo
In this webinar, Wesley Stolp, Kareo’s Solutions Director for the Managed Billing service, will teach you how to analyze your practice’s financial health, using the tools you already have to help you get paid and save time.
Wes’ in-depth review of revenue cycle management will include:
-Common practice management pitfalls that generate missed revenue opportunities
-The 3 key KPIs you need to analyze your entire billing report and how they work together to create a successful business
- Which revenue levers will help you expand your current earnings
Your practice has the potential to generate more revenue - the key is knowing where to look.
13 Steps to Limit Credentialing Mistakes Before They HappenKareo
TriZetto Provider Solutions, a Cognizant Company, will discuss critical steps needed to ensure a successful credentialing turnaround. TriZetto will share best practices and the common pitfalls to avoid to ensure that providers are able to get up and running faster than ever.
Regulatory Outlook: Knock MACRA Out of the ParkKareo
Review the latest changes to the regulatory landscape, including HIPAA, MACRA, and the NC HIE. Learn how these changes impact your clients and your business.
Addressing the Data Security Risks of Cloud-Based SoftwareKareo
Kareo’s Security Team, Jesse Salmon (Information Security Manager) and Tim Nabhani (Security Architect), will go over some of the biggest risks and misconceptions in data security as it relates to the cloud. They will also share some key security measures to look for when evaluating a cloud-based solution.
Take an in-depth look at the new Kareo Dashboard and how this enhanced workflow will improve client satisfaction and first pass acceptance rates (FPAR).
Avoid the Burnout of Owning Your Own Medical PracticeKareo
In this live webinar, Healthcare Business Consultant Aimee Heckman will:
-Identify the main causes of physician burnout, from a provider and office manager standpoint
-Provide solutions to easily implement in your daily workflow to reduce the chances of burnout
-Discuss how you can maintain a healthy balance going forward
Learn how to identify and track indicators of your company's financial health. Dave Justus, Kareo's Chief Financial Officer, and Ted Stack, founder of Falcon Capital Partners, will discuss the key performance benchmarks and insights you should pay attention to when working to optimize your billing company business.
Key Considerations When Choosing Cloud-Based SoftwareKareo
Practice Management software is a critical component of any medical billing company. As technology continues to advance, 'cloud-based’ is being touted more than ever. Join us as we take a deeper look at what a cloud-based solution can offer your business, discuss the key features and benefits of transitioning to the cloud, how to ensure that you have the support needed for a smooth transition, and the data security red flags you should be looking out for.
2019-05 Maximize Your Revenue with 3 Key Medical Billing KPIsKareo
In this webinar, Wesley Stolp, Kareo’s Solutions Director for the Managed Billing service, will teach you how to analyze your practice’s financial health, using the tools you already have to help you get paid and save time.
Wes’ in-depth review of revenue cycle management will include:
-Common practice management pitfalls that generate missed revenue opportunities
-The 3 key KPIs you need to analyze your entire billing report and how they work together to create a successful business
- Which revenue levers will help you expand your current earnings
Your practice has the potential to generate more revenue - the key is knowing where to look.
13 Steps to Limit Credentialing Mistakes Before They HappenKareo
TriZetto Provider Solutions, a Cognizant Company, will discuss critical steps needed to ensure a successful credentialing turnaround. TriZetto will share best practices and the common pitfalls to avoid to ensure that providers are able to get up and running faster than ever.
Regulatory Outlook: Knock MACRA Out of the ParkKareo
Review the latest changes to the regulatory landscape, including HIPAA, MACRA, and the NC HIE. Learn how these changes impact your clients and your business.
Addressing the Data Security Risks of Cloud-Based SoftwareKareo
Kareo’s Security Team, Jesse Salmon (Information Security Manager) and Tim Nabhani (Security Architect), will go over some of the biggest risks and misconceptions in data security as it relates to the cloud. They will also share some key security measures to look for when evaluating a cloud-based solution.
Take an in-depth look at the new Kareo Dashboard and how this enhanced workflow will improve client satisfaction and first pass acceptance rates (FPAR).
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
Insurance Reimbursement Workflow: Tracey Peyton and Suzi GrassoKareo
This document provides best practices for medical practices to achieve clean insurance claims and quicker reimbursements. It summarizes the key areas medical practices should focus on, including proper setup of billing settings, daily review of clearinghouse reports, accurate charge entry, timely claim submission, and proper payment posting. The document also highlights various workflow efficiencies that can be gained in Kareo, such as adding users and providers directly in the platform, electronic charge capture, and auto-sending eligible claims.
How Your Medical Practice Can Exceed a 95% Clean Claims RateKareo
Industry thought-leader and revenue cycle management expert, Elizabeth Woodcock, Principal, Woodcock& Associates, will discuss how achieving clean claims at first submission positively impacts medical practices. She will specifically address what insurance changes to expect with the start of a new year, and how to identify and prevent claim rejections and denials so your medical practice can exceed a 95% clean claims rate in 2020.
This document outlines information from a webinar about getting paid in 2017. It discusses upcoming Medicare payment changes, including specialty-specific rate adjustments and new codes for chronic care management and collaborative care. It also covers the Quality Payment Program, which replaces previous programs and involves either improving quality through MIPS or participating in an Advanced APM for a payment bonus. The webinar concluded with information about how the medical practice software company Kareo can help practices manage billing, coding and other operations.
As 2018 is coming to a close, many independent practices are wondering what to expect in 2019. Patient financial responsibility continues to be a challenge for many practices. The Quality Payment Program (MIPs) continues to evolve. CMS is proposing changes to the way E/M visits are paid. HIPAA data breaches are more prevalent than ever, with several large payers and healthcare organizations receiving large fines in 2018.
In this information-packed webinar, we'll discuss:
-CMS Proposed changes to E/M payment and documentation requirements
-Updates to the Quality Payment Program
-Maximizing payer revenue through fee schedule review and opting out of “Accelerated Payments”
-Understanding generational differences in patient payment habits that will improve your overall patient collections
-Changes to the ACA taking effect in 2019
-HIPAA breaches and how you can mitigate the risk in your practice
Telehealth, Coding and Billing Guidance for COVID-19Kareo
Kareo’s Subject Matter Expert for Billing, Terri Joy, MBA, CPC, CGSC, COC, CPC-I will provide you with everything you need to know about telehealth, coding and billing for COVID-19.
In this webinar, Terri will:
-Discuss new and changing government regulations around telehealth services
-How to bill for COVID-19 services
-Best practices for leveraging technology to keep your patients and staff safe and healthy
The Only Complete Technology Platform for Your Independent PracticeKareo
Who is Kareo?
Kareo makes it easier and more rewarding for you to run an independent medical practice. We offer the only cloud-based, clinical and business management technology platform dedicated to serving the unique needs of independent practices. Our software helps you find and engage with patients, run a smarter business, provide better care, and get paid faster. More than 35,000 healthcare providers rely on Kareo with nearly 150,000 users logging in to our software every day.
How is Kareo Different?
Unlike other companies that built their offering for large medical groups or hospitals, Kareo is purpose-built for the work flows and unique needs of the independent practice.
The result is an affordably-priced platform without the bells and whistles that you don’t need.
Kareo is Friendly, Flexible, and Transparent
We run our company based on business practices that are friendly, flexible, and transparent because we know you are relying on us to help you succeed.
As a Kareo customer, you’ll feel appreciated and supported due to the many benefits including:
• Free onboarding including access to your own Success Coach
• No long-term contracts and flexibility to adjust your subscription without penalty
• A clear and simple pricing model that offers affordable ways to grow your practice
• Easy access to support via phone, chat, and email at no additional cost
The business of medicine is changing quickly. Government and commercial payers know that we're paying more for healthcare and we're getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.
Setting your practice or client’s practice up for success with achieving clea...Kareo
A nationally recognized speaker, Elizabeth Woodcock, discusses what’s new for 2022 and action steps your practice (or your client’s practice) can take to protect itself from losses due to denied claims.
She will go over:
- The current state of the industry
- Pressure from surges in demand and staffing crisis
- No mercy from insurers as denials rise
- New reimbursement rules for 2022 increase complexity
Getting Paid in 2021: New Year, Fresh Perspective, More RevenueKareo
In this webinar, Aimee will:
-Review the state of the industry in 2020, including CMS waivers, HIPAA enforcement and surprise medical bills
-Expand on the E/M updates you need to know for 2021
-Provide tips and tricks to help you remove roadblocks to getting paid, including coding, additional collection methods, supporting documentation and the reset of deductibles
Kareo Billing Product Overview and Training: Success SummitKareo
This document provides an overview and training on Kareo's billing product. The agenda includes introductions, reviewing insurance enrollment enhancements, sending clean claims, improving patient collections, and a Q&A session. Key highlights include new insurance enrollment dashboards for tracking progress, tools for fixing rejected claims, collecting patient payments through email statements and credit card processing, and categories for managing patient collections.
Collecting Patient Payments During COVID-19 and Beyond - a Blueprint for SuccessKareo
The impact of COVID-19 is substantial and the way healthcare providers practice medicine has changed, and it’s not going back. Make sure your business has the right blueprint for success so you can continue collecting patient payments while providing quality care to keep your patients healthy and your practice profitable.
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
Top 10 Medical Billing KPIs That Show Where Your Practice is Losing MoneyKareo
Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Overcoming Telehealth Barriers to Mobilize Your Practice and Maximize RevenueKareo
In this live webinar, Director of Product Marketing and Partner Alliances, Sonny Singh, will:
-Discuss current industry trends and telehealth statistics
-Outline what healthcare services can be provided remotely
-Discuss how offering a telehealth option (including telemedicine) will help your practice grow amidst uncertainty
-Address the common pitfalls that you told us you’re experiencing
Adam Gobin presented on Emory Healthcare's denial management process. They applied management engineering techniques like DMAIC to streamline denial workflows through hyper-specialization and centralization. Key steps included defining denial categories, measuring trends through reports, analyzing patterns, improving through standardized workflows, and controlling quality. This led to significant improvements such as reduced write-offs, registration denials, and medical record requests as well as increased payments for aged claims. Lessons included planning resources, stakeholder buy-in, and using standardized reporting for accountability.
How MIPS/MACRA Impacts Your Clients: Kareo Success SummitKareo
kareo.com - There's no reason for any eligible clinician to pay a penalty to Medicare. Learn how practices can deliver value-based care and get the maximum positive incentives available in 2018. Learn some practical examples of how you can shepherd your clients through regulatory challenges.
The 2018 Kareo Success Summit offered key industry insights, best practice training, networking and idea-sharing to support the success of medical billing companies across the country.
Kareo is an easy-to-use, cloud-based business growth platform built for medical billing companies and the independent practices they serve.
Marina Verdara is a Sr. Training Specialist for CMS Incentive Programs.
Visit kareo.com/billing-companies to learn more.
During this webinar, we'll review CMS regulations and what’s required from providers for both Price Transparency and the No Surprises Act. We'll review strategies for implementation of both and talk about how CMS is currently responding to providers that haven't complied with Price Transparency requirements yet.
Simple Steps to Avoid the 7% MIPS Penalty for 2019Kareo
Join Marina Verdara, Kareo’s Sr. Training Specialist, as she provides you with simple steps to avoid the 7% MIPS penalty, including how you can check a clinician’s eligibility and where you can earn points for each category. She will also provide you with the resources to help you prepare for 2020.
How to Earn Your 9% MIPS Incentive Despite 2020 ChallengesKareo
In this webinar, Sr. Training Specialist, Marina Verdara, will provide you with the information and tools you need to ensure that you or your billing clients’ practices avoid receiving monetary penalties related to MIPS.
MACRA/MIPS Tips: Don't Leave Money on the TableKareo
2022 is the sixth year of the CMS Incentive Program, MACRA /MIPS, and as a practice or billing company, you have seen payment adjustments that have affected your business in more than one way. The biggest impact is payment adjustments, where we see up to a negative 9% of claims paid. So what can you do about it, and how can we minimize those adjustments?
Marina Verdara, CMS Incentive Program SME and Sr. Training Specialist at Kareo will explore what you need to know about MACRA/MIPS and how you can improve your bottom line. She will walk you through:
-The overview of MACRA
-MIPS eligibility, training, and tracking progress for providers
-Billing companies & the claims submission process
-Supporting documentation & attestation
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
Insurance Reimbursement Workflow: Tracey Peyton and Suzi GrassoKareo
This document provides best practices for medical practices to achieve clean insurance claims and quicker reimbursements. It summarizes the key areas medical practices should focus on, including proper setup of billing settings, daily review of clearinghouse reports, accurate charge entry, timely claim submission, and proper payment posting. The document also highlights various workflow efficiencies that can be gained in Kareo, such as adding users and providers directly in the platform, electronic charge capture, and auto-sending eligible claims.
How Your Medical Practice Can Exceed a 95% Clean Claims RateKareo
Industry thought-leader and revenue cycle management expert, Elizabeth Woodcock, Principal, Woodcock& Associates, will discuss how achieving clean claims at first submission positively impacts medical practices. She will specifically address what insurance changes to expect with the start of a new year, and how to identify and prevent claim rejections and denials so your medical practice can exceed a 95% clean claims rate in 2020.
This document outlines information from a webinar about getting paid in 2017. It discusses upcoming Medicare payment changes, including specialty-specific rate adjustments and new codes for chronic care management and collaborative care. It also covers the Quality Payment Program, which replaces previous programs and involves either improving quality through MIPS or participating in an Advanced APM for a payment bonus. The webinar concluded with information about how the medical practice software company Kareo can help practices manage billing, coding and other operations.
As 2018 is coming to a close, many independent practices are wondering what to expect in 2019. Patient financial responsibility continues to be a challenge for many practices. The Quality Payment Program (MIPs) continues to evolve. CMS is proposing changes to the way E/M visits are paid. HIPAA data breaches are more prevalent than ever, with several large payers and healthcare organizations receiving large fines in 2018.
In this information-packed webinar, we'll discuss:
-CMS Proposed changes to E/M payment and documentation requirements
-Updates to the Quality Payment Program
-Maximizing payer revenue through fee schedule review and opting out of “Accelerated Payments”
-Understanding generational differences in patient payment habits that will improve your overall patient collections
-Changes to the ACA taking effect in 2019
-HIPAA breaches and how you can mitigate the risk in your practice
Telehealth, Coding and Billing Guidance for COVID-19Kareo
Kareo’s Subject Matter Expert for Billing, Terri Joy, MBA, CPC, CGSC, COC, CPC-I will provide you with everything you need to know about telehealth, coding and billing for COVID-19.
In this webinar, Terri will:
-Discuss new and changing government regulations around telehealth services
-How to bill for COVID-19 services
-Best practices for leveraging technology to keep your patients and staff safe and healthy
The Only Complete Technology Platform for Your Independent PracticeKareo
Who is Kareo?
Kareo makes it easier and more rewarding for you to run an independent medical practice. We offer the only cloud-based, clinical and business management technology platform dedicated to serving the unique needs of independent practices. Our software helps you find and engage with patients, run a smarter business, provide better care, and get paid faster. More than 35,000 healthcare providers rely on Kareo with nearly 150,000 users logging in to our software every day.
How is Kareo Different?
Unlike other companies that built their offering for large medical groups or hospitals, Kareo is purpose-built for the work flows and unique needs of the independent practice.
The result is an affordably-priced platform without the bells and whistles that you don’t need.
Kareo is Friendly, Flexible, and Transparent
We run our company based on business practices that are friendly, flexible, and transparent because we know you are relying on us to help you succeed.
As a Kareo customer, you’ll feel appreciated and supported due to the many benefits including:
• Free onboarding including access to your own Success Coach
• No long-term contracts and flexibility to adjust your subscription without penalty
• A clear and simple pricing model that offers affordable ways to grow your practice
• Easy access to support via phone, chat, and email at no additional cost
The business of medicine is changing quickly. Government and commercial payers know that we're paying more for healthcare and we're getting worse results. Patients know it too. The role of independent practices, their reimbursement models, and how they care for patients are all changing as a result.
Setting your practice or client’s practice up for success with achieving clea...Kareo
A nationally recognized speaker, Elizabeth Woodcock, discusses what’s new for 2022 and action steps your practice (or your client’s practice) can take to protect itself from losses due to denied claims.
She will go over:
- The current state of the industry
- Pressure from surges in demand and staffing crisis
- No mercy from insurers as denials rise
- New reimbursement rules for 2022 increase complexity
Getting Paid in 2021: New Year, Fresh Perspective, More RevenueKareo
In this webinar, Aimee will:
-Review the state of the industry in 2020, including CMS waivers, HIPAA enforcement and surprise medical bills
-Expand on the E/M updates you need to know for 2021
-Provide tips and tricks to help you remove roadblocks to getting paid, including coding, additional collection methods, supporting documentation and the reset of deductibles
Kareo Billing Product Overview and Training: Success SummitKareo
This document provides an overview and training on Kareo's billing product. The agenda includes introductions, reviewing insurance enrollment enhancements, sending clean claims, improving patient collections, and a Q&A session. Key highlights include new insurance enrollment dashboards for tracking progress, tools for fixing rejected claims, collecting patient payments through email statements and credit card processing, and categories for managing patient collections.
Collecting Patient Payments During COVID-19 and Beyond - a Blueprint for SuccessKareo
The impact of COVID-19 is substantial and the way healthcare providers practice medicine has changed, and it’s not going back. Make sure your business has the right blueprint for success so you can continue collecting patient payments while providing quality care to keep your patients healthy and your practice profitable.
In this live webinar, Valora outlines the three main stages of starting a medical practice:
1) Planning - creating a business plan, setting a budget and outlining your timeline
2) The Nuts and Bolts - finding a location, credentialing, administrative setup, and choosing the right technology for your needs
3) Opening - hiring staff and activating your marketing plans
Top 10 Medical Billing KPIs That Show Where Your Practice is Losing MoneyKareo
Kareo’s Billing Subject Matter Expert, Terri Joy, MBA, CPC, CGSC, COC, CPC-I, shares the 10 medical billing KPIs you need to know to prevent your practice from losing money.
Overcoming Telehealth Barriers to Mobilize Your Practice and Maximize RevenueKareo
In this live webinar, Director of Product Marketing and Partner Alliances, Sonny Singh, will:
-Discuss current industry trends and telehealth statistics
-Outline what healthcare services can be provided remotely
-Discuss how offering a telehealth option (including telemedicine) will help your practice grow amidst uncertainty
-Address the common pitfalls that you told us you’re experiencing
Adam Gobin presented on Emory Healthcare's denial management process. They applied management engineering techniques like DMAIC to streamline denial workflows through hyper-specialization and centralization. Key steps included defining denial categories, measuring trends through reports, analyzing patterns, improving through standardized workflows, and controlling quality. This led to significant improvements such as reduced write-offs, registration denials, and medical record requests as well as increased payments for aged claims. Lessons included planning resources, stakeholder buy-in, and using standardized reporting for accountability.
How MIPS/MACRA Impacts Your Clients: Kareo Success SummitKareo
kareo.com - There's no reason for any eligible clinician to pay a penalty to Medicare. Learn how practices can deliver value-based care and get the maximum positive incentives available in 2018. Learn some practical examples of how you can shepherd your clients through regulatory challenges.
The 2018 Kareo Success Summit offered key industry insights, best practice training, networking and idea-sharing to support the success of medical billing companies across the country.
Kareo is an easy-to-use, cloud-based business growth platform built for medical billing companies and the independent practices they serve.
Marina Verdara is a Sr. Training Specialist for CMS Incentive Programs.
Visit kareo.com/billing-companies to learn more.
During this webinar, we'll review CMS regulations and what’s required from providers for both Price Transparency and the No Surprises Act. We'll review strategies for implementation of both and talk about how CMS is currently responding to providers that haven't complied with Price Transparency requirements yet.
Simple Steps to Avoid the 7% MIPS Penalty for 2019Kareo
Join Marina Verdara, Kareo’s Sr. Training Specialist, as she provides you with simple steps to avoid the 7% MIPS penalty, including how you can check a clinician’s eligibility and where you can earn points for each category. She will also provide you with the resources to help you prepare for 2020.
How to Earn Your 9% MIPS Incentive Despite 2020 ChallengesKareo
In this webinar, Sr. Training Specialist, Marina Verdara, will provide you with the information and tools you need to ensure that you or your billing clients’ practices avoid receiving monetary penalties related to MIPS.
MACRA/MIPS Tips: Don't Leave Money on the TableKareo
2022 is the sixth year of the CMS Incentive Program, MACRA /MIPS, and as a practice or billing company, you have seen payment adjustments that have affected your business in more than one way. The biggest impact is payment adjustments, where we see up to a negative 9% of claims paid. So what can you do about it, and how can we minimize those adjustments?
Marina Verdara, CMS Incentive Program SME and Sr. Training Specialist at Kareo will explore what you need to know about MACRA/MIPS and how you can improve your bottom line. She will walk you through:
-The overview of MACRA
-MIPS eligibility, training, and tracking progress for providers
-Billing companies & the claims submission process
-Supporting documentation & attestation
2016 MIPS Final Rule: What you need to know NOWBen Quirk
Find out why you need to pay attention to this Final Rule and what adjustments you need to make to ensure you end up on the winning side of MIPS. It's a complicated program, and results from the Final Rule don't make it any easier.
MACRA consolidates existing Medicare quality programs and establishes two pathways for physicians: MIPS and APMs. MIPS assesses performance in four categories (quality, cost, improvement activities, advancing care information) and adjusts payments up or down based on a composite score. It allows physicians to ease into reporting over multiple years. APMs provide an alternative for physicians meeting thresholds in qualifying models, exempting them from MIPS and providing bonus payments through 2024. MACRA aims to shift Medicare payments from volume to value over time through 2026.
MACRA consolidated several existing Medicare quality programs and introduced new payment models. It established two tracks for physician payment and quality programs starting in 2017 - MIPS and Advanced APMs. MIPS consolidated existing programs into four categories and allows physicians to gradually increase their participation over multiple years. Advanced APMs provide incentives for participation in alternative payment models and include models like Accountable Care Organizations. MACRA aims to reform Medicare payments to physicians and transition to value-based models.
Riding the Rapids of Payment Reform: Downstream Effects of Quality Reporting ...Bill Presley
In this presentation, we highlighted how quality measurement programs impact reimbursement affecting your revenue. The revenue at risk in your organization. We focused on quality programs like Value-Based Purchasing (VBP), Merit-Based Incentive Program (MIPS) and Alternative Payment Models (APM) and their impact on Part A and Part B reimbursements.
It’s no surprise that reimbursement tied to quality performance is quickly becoming a reality for hospitals and physicians. CMS’ aggressive goals aimed at increasing the percentage of Medicare payments associated with quality versus quantity can be achieved through such programs as Value-based Purchasing and MACRA. This session will cover scoring methodologies, reporting requirements, reimbursement impact, infrastructure (and other resource needs), EMR tools and tactics, and workflow modifications.
Top 10 Medical Billing KPIs That Show You Where You’re Losing MoneyKareo
This webinar discussed key performance indicators (KPIs) for medical billing processes. It began with introducing the speaker and agenda. Essential KPIs were then reviewed, including first pass acceptance rate, first pass resolution rate, days in accounts receivable, and net collections. Common billing issues like denials, rejections, and under/over-coding were also addressed. The webinar provided tips to improve patient statements and audit medical records. Finally, it described how the Kareo medical billing platform can help practices enhance their billing processes by analyzing billing data and benchmarks.
The Guidebook to Medicare Access and CHIP Reauthorization Act of 2015 dispels MACRA myths and puts you in the know with easy-to-follow guidance. Interpret MACRA changes with step-by-step advice to understand and master MACRA’s final rule.
Preparing providers to earn revenue through MACRA.pptxElixirEHR
As a healthcare provider, meeting regulatory goals is one of the most critical parts of your process, especially for MACRA as compliance leads to both positive and negative payment adjustments for all medicare part B claims. So it has become all the more critical for the healthcare clinics or providers to understand the process to stay one step ahead and be on the winning side.
In this webinar, speakers share their insights to ensure you are prepared and fully informed about the MACRA MIPS and APM process.
Some of the things we talked about:
1. What is MACRA? What are the various programs under MACRA to help providers increase revenue?
2. Eligibility and participation process for MIPS and APM program.
3. Steps that healthcare providers need to follow to make most of these compliance requirements and earn upto 9% of positive adjustment.
4. Finally, we talk about the claim submission process for MIPS.
MACRA is quickly approaching year 2. CMS recently released their 2018 Proposed Rule, and there are some significant changes everyone should be aware of.
Rather than wading through the 1,058 pages of the Proposed Rule, join CareOptimize for a look at the most important takeaways.
In less than 30 minutes, you'll learn:
Are any of your clinicians now exempt?
What is a Virtual Group, and will it save you money?
Are your practice's priorities aligned with the newly weighted categories?
How can the Proposed Rule increase your 2018 bonus?
SourceMed Therapy Q1 2016 Regulatory Update, hosted by Chief Therapy Officer David McMullan, PT. Covering news and regulatory updates for the outpatient physical therapy industry.
This slide deck provides a detailed overview of the PQRS program, including helpful information on how to report for PQRS using the claims-based reporting method. Learn how to report Quality Data Codes for PQRS on Medicare claims and avoid penalties!
During this webinar, a high-level overview of the ACO REACH Model was provided including information on the participation and eligibility requirements, Accountable Care Organization (ACO) types, payment mechanisms, and beneficiary alignment methodology.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Medicare Access and Chip Reauthorization Act (MACRA) is the law that changes how Providers are to be reimbursed. One of the key characteristics is that it rewards Providers based on value and not volume.
The Center for Medicare and Medicaid Innovation hosted a webinar on Thursday, October 8, 2015. The webinar provided an opportunity to learn more about efforts to solicit public comment on a variety of alternative payment pathways to increase value over volume.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
This document summarizes a webinar on simple steps to succeed under the Quality Payment Program (QPP) and MIPS. It outlines the agenda, speakers, an introduction to MACRA and the QPP, details on MIPS requirements and scoring, and how participants can report data. It also describes how Kareo's software can help practices meet MIPS requirements through features for quality reporting, improvement activities, and advancing care.
This document provides an overview of Medicare Advantage, including:
- Medicare Advantage originated with the 1997 Balanced Budget Act and allows beneficiaries to receive Medicare benefits through private health plans rather than traditional Medicare.
- Plans bid annually for reimbursement amounts and are paid a blended rate based on their bid and a county benchmark. Higher rated plans receive quality bonuses.
- Risk adjustment factors account for patient health risks and impact reimbursement. Proper coding of conditions is important.
- Star ratings, HEDIS, CAHPS, and HOS are used to measure plan quality and influence enrollment and marketing privileges.
- EHRs can help capture necessary data and support protocols to improve quality and star ratings.
ACOs and CINs — Where Did They Start, How Have They Evolved, and Where Are Th...Health Catalyst
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Please join Health Catalyst Senior Vice President Dr. Amy Flaster and Population Health Management Consultant Jonas Varnum as they discuss the evolution of the ACO and CIN models, what new tools ACOs employ today to promote success, and lessons learned from organizations that have succeeded in alternative payment models. They will dive deep into lessons learned in addition to providing a primer on what has always been and continues to be vitally important to success in value based care. Specifics they will cover include:
- Approaches to simplify quality metric reporting
- Enhanced methodology that zeroes in on identifying high-value opportunities to improve patient populations
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Dr. Flaster and Mr. Varnum’s combined experience make them uniquely qualified to guide you in your ACO or CIN journey. Dr. Flaster comes from a clinical background where she worked as Associate Medical Director at Partners HealthCare - one of the largest ACOs in the country. Mr. Varnum is a professional services strategy leader with demonstrated expertise delivering payment model transformation and helping providers and payers to strategically adjust their operations.
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3. kareo.com 33
How to Participate Today
Type your questions
Download today’s resources
View today’s presentation
4. kareo.com 44
Connect via Social
twitter.com@GoKareo
facebook.com/GoKareo
linkedin.com/company/kareo
5. kareo.com 55
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
live 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. kareo.com 66
Speaker
Marina is a Sr. Training Specialist
guiding Kareo customers to higher
levels of success with their CMS
Incentive Program reporting. Marina
has more than eight years of
experience working directly with
hundreds of small practice clinicians
on a variety of projects. Her specialty
is working with clients on CMS
Incentive programs such as
Meaningful Use, PQRS, and MACRA.
Marina Verdara, MBA
8. kareo.com 88
What is MACRA?
MACRA
MIPS
Quality
45%
-Report up to 6
measures
-Full year reporting
Promoting
Interoperability
25%
-4 objectives
-90 days up to a full
year reporting
Improvement
Activities
15%
- Submit 40 points to
earn full credit
Cost
15%
-10 measures
evaluated
-Data submission not
required
APM
ACOs
Specialty Specific
Programs
State Specific
Programs
9. kareo.com 99
2019 APMs
2019 Approved APMs
• Bundled Payments for Care Improvement Advanced Model (BPCI Advanced)
• Comprehensive ESRD Care (CEC) Model LDO Arrangement
• Comprehensive ESRD Care (CEC) Model non-LDO Two-Sided Risk Arrangement
• Comprehensive ESRD Care (CEC) –Model non-LDO one-Sided Risk Arrangement
• Comprehensive Primary Care Plus (CPC+)
• Medicare Accountable Care Organization (ACO) Track 1+ Model
• Next Generation ACO Model
• Shared Savings Program - Track 2
• Shared Savings Program - Track 3
• Oncology Care Model (OCM) - Two-Sided Risk
• Oncology Care Model (OCM) - One-Sided Risk
• Vermont Medicare ACO Initiative
• Maryland Primary Care Program
• Independence at Home Demonstration
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Alternative Payment Models (APMs)
Important facts to know about APMs:
• These are Medicare Incentive programs
• They are managed by local medical entities such as hospitals,
medical groups, or IPAs
• Most are known ACOs
• The APM/ACO administrator assigns quality measures to
clinicians
• Clinicians might also be required to submit data for MIPS
• Every kind of APM has it’s own requirements and thresholds.
*The best thing a clinician can do is to partner up with the medical entity who invited
them to join the APM
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Merit-based Incentive Payment Systems (MIPS)
Quality
• 6 Measures or a Full
Specialty Set
• 1 Outcome
Measure or 1 High
Priority Measure
•Improvement
Activities
• 10 Measures Evaluated
• Based on Part B Claims
Submitted All Year
Long
• No Additional Data
Submission is Required
Promoting
Interoperability
• ePrescribing
• HIE (Health
Information Exchange)
• Provider to
Patient Exchange
• Public Health &
Clinical Data Exchange
• Protect Patient
Health information
•Cost
• Submit 40 Points
• Medium= 10 Points
• High= 20 points
• Points Double for
Clinicians with a
Special Status
Clinicians will be scored based on performance submitted in four categories:
12. kareo.com 1212
Quality
• Report 6 measures; or a complete specialty set
• Include 1 outcome or a high-priority measure
• Bonus points awarded if more than 2 outcome or high-priority
measures are submitted
• Full year reporting (Jan-Dec)
• Must report at least 20 cases for each measure to be fully scored
• Must meet the data completeness requirement standard of 60%
• Small practices earn up to 6 bonus points in the quality category
• Multiple collection types (submission methods) include claims
and registry submission
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Promoting Interoperability
Eligible clinicians will be scored on their performance on four objectives and one
mandatory measure:
Objective Measures Maximum Points
ePrescribing ePrescribing 10 points
Prescription Drug Monitoring Program Optional
Verify Opioid Treatment Agreement Optional
Health Information
Exchange
Send Health Information 20 points
Receive & Incorporate Health Information 20 points
Provider to Patient
Exchange
Provide Patients Electronic Access to their Health
Information
40 points
Public Health & Clinical
Data Exchange
Report to two different public health agencies or
clinical data registries
10 points
* Protect Patient
Health Information
A Security Risk Assessment is mandatory, but will
not be Scored
*Mandatory
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• The goal is to submit 100 points
• Measures removed:
• Patient Education
• Secure Messaging
• View, Download or Transmit (VDT)
• Patient-Generated Health Information
• Exclusions available for some measures
• Submission options include registry and manual
submission via the attestation website
Promoting Interoperability
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Improvement Activities
To earn full credit (15%) in this category, clinicians must submit a combination of
activities that add up to 40 points:
• Medium= 10 points
• High= 20 points
• 2 high-weighted activities
• 1 high-weighted activity and 2 medium- weighted activities
• 4 medium- weighted activities
• Clinicians with a special status will earn double points for each activity. A special
status is
• Small practice
• Non-patient facing
• Rural
• Health Professional Shortage Area (HPSA)
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• Supporting documentation:
• Screenshots: EHR and/or PM/Billing
• Create policies and procedures
• Write a statement to explain how you believe
you met your selected activity, date and sign it
• Reports
• Screenshots of a website such as a drug
monitoring website
• Save supporting documentation for a minimum of six
years
• Save supporting documentation in a MIPS audit binder
• Submission types include registry and manually via the
attestation website
Improvement Activities
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Cost
• 10 cost measures will be evaluated
• If there are not enough attributed beneficiaries
for any of the 10 measures to be scored, the
Cost performance category percentage will be
redistributed to the Quality performance
category.
• No additional data submission is required
• Full year evaluation
• You can learn more about it at:
https://qpp.cms.gov/about/resource-library
20. Kareo Confidential 2020
Who is Eligible for the QPP?
Clinicians are eligible if they meet or exceed the low-volume threshold:
1. Bill Medicare over $90,000 in Part B allowed charges a year, and
2. Provide care to more than 200 Medicare Part B patients, and
3. Provide 200 or more covered professional services to Part B patients
Clinician Types:
• Physician
• Physician Assistant
• Nurse Practitioner
• Clinical Nurse Specialist
• Certified Registered Nurse
Anesthetist
• Physical Therapist
• Occupational Therapist
• Clinical Psychologist
• Qualified Speech-Language Pathologist
• Qualified Audiologists
• Registered dietitians or Nutrition Professionals
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Eligibility Determination
Eligible Opt-In Option Voluntary Participation
Meets or Exceeds ALL
Low-Volume Threshold
Criteria
Meets or Exceeds One or Two
Low-Volume Threshold
Criteria
Does NOT Meet or Exceed
ANY Low-Volume Threshold
Criteria
≥ 90k in Part B Charges,
and
≥ 200 Part B Beneficiaries
and
≥ 200 Professional Services
≥ 90k in Part B Charges,
or
≥ 200 Part B Beneficiaries,
or
≥ 200 Professional Services
< 90k in Part B Charges
< 200 Part B Beneficiaries
< 200 Professional Services
Will Receive Feedback Will Receive Feedback Will Receive Feedback
Eligible for a Payment
Adjustment
Eligible for a Payment
Adjustment
NOT Eligible for a Payment
Adjustment
The Review Periods to determine a clinician’s eligibility is:
• October 1, 2017 – September 30, 2018
• October 1, 2018 – September 30, 2019
There are three participation options:
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Payment Adjustments
According to the CMS’s 2017 QPP Experience Report:
0 - 2
4 - 74
75 - 100
2017
Group Size
Negative Payment
Adjustment Count #
Individual (1) 2,225
Small Group (2 - 15) 20,014
Total 22,239 3
Group Size
Neutral Payment
Adjustment Count #
Positive Payment
Adjustment Count #
Individual (1) 20,137 55,240
Small Group (2 - 15) 670 23,539
Total 20,807 78,779
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Payment Adjustments
Starting January 2019, Medicare Administrative Contractors (MAC) will use the
three code types listed below to identify payment adjustments for the 2017
reporting year:
• Claim Adjustment Reason Code (CARC): 144 for a positive payment
adjustment and 237 for a regulatory penalty
• Remittance Advice Remark Codes (RARCs): N807 –MIPS based payment
adjustment
• Group Code: CO for a regulatory requirement that resulted in an adjustment
Clinicians will also receive a Medicare Summary Notice (MSN) every three
months. If a payment adjustment was made, the MSN will indicate the following
message:
“This claim shows a quality reporting program adjustment”
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Payment Adjustments
Important facts about payment adjustments
for 2017:
• 93% of clinicians received a positive payment
adjustment. Code used is CARC 144
• 5% received a negative payment adjustment.
Code used is CARC 237
• ONLY 2% of clinicians received a neutral
status
• The national mean MIPS score was 74.01
• Clinicians in small practices
received an average score of 43.46
points
• The national mean APM score was 87.64
93%
5%
2%
2017 PAYMENT
ADJUSTMENTS
Positive Payment
Adjustment
Negative
Payment
Adjustment
Neutral
26. kareo.com 2626
Payment Adjustments
• The minimum positive payment adjustment is 0.28%
• The maximum positive payment adjustment for clinicians who submitted 70 to 100
points is
• The negative 4% payment adjustment taken away from providers who ignored
MIPS or submitted less than 3 points in 2017, is being used to pay the winners
1.88%
This Photo by Unknown Author is
licensed under CC BY
Which side of the scale are you on?
28. kareo.com 2828
MIPS 2019 Point Scoring System
Up to -7% Payment
Adjustment
Neutral
Neutral or a small
Positive Payment
Adjustment
Neutral or up to a +7%
Payment Adjustment
0 - 29
30 - 74
75 - 100
Quality
45%
PI
25%
IA
15%
Cost
15%
100%
Submit 60
points to earn
full credit
Submit 100
points to earn
full credit
Submit 40
points to Earn
full credit
Earn 100
points to earn
full credit
30
29. kareo.com 2929
What Can You Do?
Understand MACRA
Confirm your MIPS/APM eligibility status
Sign up for training
Take advantage of resources available to you
Take Action
Create a team: include clinicians, staff and billers
Refine your team’s knowledge on MIPS
Select your measures and submission options
• Claims, registry, manual attestation
Set goals and expectations and meet regularly
• Find ways to incentivize team members for their good work. Create contests.
Make it fun!
Track your progress. Run reports twice per month
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What Can You Do?
Attest
Run your final reports in January 2020:
Full Year for the Quality category
90 days up to a full year for the Promoting Interoperability Category
Gather and save any supporting documentation for your selected
improvement activities
Submit your data prior to March 31, 2020
Number of
Clinicians
Total Part B claims
paid per Year
Negative
7%
Assuming the national
maximum positive payment
adjustment is 2%
1 150,000 $10,500 $3,000
2 220,000 $15,400 $4,400
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Recommendations
Clinicians
Calculate your possible financial gains or losses and ask yourself:
Can I afford to leave money on the table?
Am I willing to modify my workflow to improve my scores?
Create a customized MIPS plan for your team
Billing companies
Calculate your clinician’s possible financial losses and how those financial losses
could impact you
Partner up with clinicians to help them earn a positive payment
adjustment
Should you incentive clinicians for meeting MIPS?
Should you setup recurring meetings?
Should you be involved in the attestation process?
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Awards and Rankings
Growth Awards
The speed at which medical
practices are moving to Kareo and
referring it to other providers.
Software Reviews and Rankings
3rd party recognition, driven by
direct customer feedback, equals
trust and credibility.