Home Forums Discussions General Discussion PQRS- how do you do it?

For the last 3 years I have been doing PQRI by having a worksheet included with the superbill for each of the Medicare patients. I do the rheumatoid arthritis group, as well as two of the osteoporosis and the electronic billing modules. The biller can add the billing codes with some hotkeys, as they do for the other claims.

Anyway, since I'm going to be entering the billing codes from inside of the emr, I am trying to figure out the best workflow for the office.

My concerns:

There are 32 different billing codes for 8 questions to add to the claim. I might be able to learn them, but the time taken to add 8 billing codes makes me wonder if my biller's time should be used instead of mine.

I believe there is a requirement to document the process, and four of the modules require documenting the reason that we are not doing The Medicare Way. Jotting down the reason why Mrs. Jones is not on treatment for her osteoporosis is easy with the worksheet, which is then scanned to the patient's folder, and available for audit.

I have not explored the registry option, so would like to know exactly how that works. How many clicks or text entry for each patient?

I am trying to figure out how to be as lazy as possible and continue to do PQRS. How do you do PQRS workflow with AC?

Dan,

Doing the registry for 3 years with great success. 30 patients, mostly entered by my staff into an online database, with a few Rheumatoid Arthritis q's...do you use DMARDs? TB checking? Wean steroids?

It is very useful as I would never have thought of doing all of this! Kudos to CMS!

PM me or have your staff call my office manager.....

Thanks Neil,

It appears you are doing both the registry and not all of your Medicare patients.

I've been doing a worksheet on every Medicare patient, as almost all of them get an eRx.

The worksheet helps generate revenue, because it prevents patients falling thru the cracks from being busy. It prompts tapering Prednisone, doing a HAQ, PPD, getting a DEXA, and starting a med for osteoporosis, all reasons for another visit soon.

So I want to do PQRS on every patient, but how would that work with a registry? How much work is it?

And does anyone enter PQRS billing codes into AC after the visit?

Thanks

Medicare allows you to report via CMS1500 claim forms, on every qualifying patient.
Or the other option is to supply a sample of relevant patient types through a registry (30 patients).

I am a D.O. and the American Osteopathic Association has a web portal through which I pay about $150 to access the registry tool. I go online and input data on 30 patients. I am using a different disease state, diabetes. However I could pick any number of disease states to sample.

After selecting the diagnosis I am going to report, the AOA website provides me the worksheets to use. My staff and I go through the relevant patient charts and record the data on the worksheets. Then we go online and input the data into the web-based registry.

Once the data is in, I get confirmation immediately that it's complete and received by the AOA. They submit the data on my behalf. I see reimbursement by Medicare about 9 months later.

This whole process takes about 4 hours and two staff to complete. it's not that painful. The registry process is much much easier for us than reporting on every Medicare B patient who is a diabetic (which is tons of them).

I also used a registry which means only submitting a sample of patients. There is no advantage that I can see to submitting additional patients through the registry. Identifying the additional issues you describe sounds worthwhile (both financially and medically) but could be done either using decision support, an AC generated report, or manually. If you use a registry, the billing codes simply become extra work.

My approach is just like adam's and with about the same time commitment.

I found this much more reliable then hoping cms got all my g codes right. After submitting I knew I would qualify 100%. (had problem like many year 1 the g code way)

I follow all my pts with the health maintenance feature of ac:

All Immunosuppressed get flu yrly, pneumo q 5 yrs, RA X-rays yrly, dxa q2, evaluation per pqri with measurement of activity, steroids, prognosis, etc. Or other as desired. This can be set in administration as rules.....