About PQRS

Physician Quality Reporting System (PQRS) is an incentive program from the Centers for Medicare and Medicaid Services (CMS), one that encourages physicians to report on the quality of their professional services as opposed to the quantity of their services. This is in an attempt to move medical professionals away from the Fee-For-Service payment structure, the traditional method of payment, toward a Pay-For-Performance (P4P) system.

What does this mean for your patients? The goal of this program is to emphasize the health in healthcare. Instead of always focusing on illness and symptoms, the goal is incentivize keeping healthy people healthier for longer. 

It's understandable that some practices would rather keep to the old Fee-For-Service payment structure. And why not? Why change something that looks like it works pretty well? Why break old habits? Well, according to the CMS website, "Individual eligible professionals who meet the criteria for satisfactory submission of Physician Quality Reporting quality measures data via one of the reporting mechanisms above for services furnished during a 2013 reporting period will qualify to earn a Physician Quality Reporting incentive payment equal to 0.5% of their total estimated Medicare Part B Physician Fee Schedule (PFS) allowed charges for covered professional services furnished during that same reporting period."

If the benefits don't seem like enough of an incentive, there are future consequences for not changing to PQRS. According to the American Medical Association (AMA), in the year 2015, Eligible Professionals (EPs) who do not participate in PQRS and successfully report during the 2013 reporting period will be assessed a 1.5% reduction in all Medicare Fee-For-Service payments. This applies to Medicare Part B covered professional services furnished by the eligible professional during 2015 or any subsequent year.

In 2016, EPs who do not participate in PQRS and successfully report during the 2014 reporting period will be assessed a 2% reduction in all Medicare fee-for-service payments. This applies to Medicare Part B covered professional services furnished by the eligible professional during 2015 or any subsequent year.

Want to avoid these substantial losses? It's easy to start using PQRS. Just follow these simple steps and do it yourself in less than 5 minutes!

1. Go to Settings -> People and Places -> Payor.
2. Search under the Payor column for MED (Medicare).
3. Hit the Options 2 tab.
4. In edit mode, check the box that says Bill Zero Balance Charges.
5. Repeat for any other Medicare payors

6. For this step, you may want to contact Client Services for setup help: Go to Settings -> Procedures -> Procedure Maintenance and create a new entry using one of your PQRS measures with a zero dollar fee. (To get started with PQRS Measures, you can view the Implementation Guide on Medicare's Website.)

7.  When you enter Evaluation & Management charges for Medicare patients (such as 99213 for an office visit), enter an accompanying Measure (or Measures) using the appropriate PQRS procedure code(s) created in step 6.  Make sure the diagnosis codes, service date, provider, and location match the E&M code. Each eligible professional must satisfactorily report on at least 50 percent of eligible instances when reporting (through submitting claims) to qualify for the incentive.

There! You're all finished and you can start collecting those benefits in the years to come!

If you are already reporting some PQRS measures and have any thoughts or advice, please share your opinion below under "Post a Comment."

Contributors: Kylie McKenzie Soder and Christine Parker

E-mail Reminders!

Tired of calling your patients to remind them about their appointments? If so, then the Confirm Appointments Via E-mail feature might interest you! Rexpert can send e-mail messages, asking your patients to confirm their upcoming appointments. And it's simple!

Access the Confirm Appointments screen by selecting Scheduling > Confirm Appointments:

Enter the date range of the appointments you wish to confirm. This Rexpert screen lists the names of the patients along with their future appointment dates. To send out a confirmation e-mail, simply select the Confirm Via E-mail button.

Note: If an e-mail address has not been entered in the patient's Account, the button will not be sensitive.

No typing is necessary; the e-mail will be sent out automatically. This is a sample of the e-mail your patients will receive:

Before you can use this feature, some set-up is necessary:

1. Update your "emailConfirmAppts" document template to be sure the wording is what you want and that your practice logo is included.
2. Update your locations with a special Billing Number entry so that when your patients click on the "Confirm My Appointment" button in their reminder e-mails, the web page to which they are directed will contain a Google Map focused on the appointment location.
3. Send us your practice logo (or find a free one at http://all-free-download.com/free-vector/medical-logo.html or http://www.pdclipart.org/thumbnails.php?album=72 or http://www.wpclipart.com/medical/) so that we can put it on the website to which patients are directed.
4. Make sure your practice has an e-mail address entered and that someone in your office is assigned to monitor this e-mail account daily.
5. Start entering e-mail addresses in Account Registration.

It will probably be easier to send us an e-mail via the Feedback Button to let us know you want to give this a try: we can quickly do most of this setup for you.

Once the confirmation e-mail has been sent, a record of that e-mail will be noted in two places: 1) the Remark section of the Confirm Appointments page.

2) Under the patient's Appointment Information in the scheduler. (Access this information by going to the scheduler and double-clicking the appointment in question.)

Voila! You're all finished!

Do you find that e-mailing patients leads to better results than calling them? Which option do you find easier when confirming patients? Let us know in the comment section below!

 Contributors: Kylie McKenzie Soder and Christine Parker

Screenshots: Editing

Sending an image via the Feedback button can significantly improve Client Service's ability to fix any problem. However, large images are often difficult to scan when the issue is confined to a relatively small area of the screen. There is an easy way to edit screenshots to pinpoint the exact location that is causing trouble.

Now, let's imagine that there is an issue involving the Wait List...

Once you have taken the Screenshot by pressing Alt-PrintScrn, you have three options. You can paste the image into a document editing program, such as Microsoft™ Word, you can open an image editing program such as Microsoft™ Paint, or you can paste the image directly into Microsoft Outlook (not Outlook Express):

This is the Windows ™ 7 version of Microsoft™ Paint, which might look very different from your version. However, the basic functions will be the same. Once you have the program open, all you need to do is press Ctrl+V to paste in the image you copied to your clipboard using the Print Screen button:

Notice that in the image editing software, you now have an image that includes your desktop icons and the task bar below. At this point, you will have to use the Select and Crop tools to choose the part of the image you want to save and to get rid of the rest of the image. After using those tools, you will only have the part of the image that you need:

You now have the option to add any other touches to the image you want. For instance, if you want to point out using text the part of the image you want noticed, you could use the Text Box button and write:

Now, you simply save the file as a JPEG, a common format for images, and e-mail it as an attachment to your Client Support provider or guidev@practice-alt.com. Make sure to include details about the image, and what your question or comment pertains to in the picture itself. At this point, the matter is out of your hands, until you receive an answer from Client Support.

Later the same day, or perhaps early the next day, you get an e-mail answering your question.

"Try changing the options at the top of the screen. Notice that there is a set of options which is currently set to Show Patients Waiting for Provider with a specific Provider chosen. Change it to the top option instead, Show All Waiting Patients, and you'll likely see the patients on the Wait List as you expected:

If this doesn't clear up the issue, please respond and further steps will be taken. Thank you!"

As you can see, the fact that you sent a screenshot cleared the matter up very quickly. Rather than having to look around in your system to see what might be going wrong, Client Support saw right away that it was possible that a single click might reveal to you the appointments you were trying to find.

One final point on the issue of screenshots relates back to the beginning of this post, and the Alt key on the keyboard. By pressing Alt+Print Screen, you can copy only the "active window" or the part of your screen which is where you last clicked with your mouse. Here is are two images, taken from the same screen, with different results because of the use of Alt+Print Screen:

1. Using just the Print Screen button:

2. Using Alt+Print Screen with the Information window as the "active" window:

In other situations, you can also use Alt+Print Screen with the entire Rexpert Session as the "active" window:

This prevents it from being necessary for you to actually edit the image or e-mail it.  Just press Alt+ Print Scrn  and check the "Include screenshot (taken with Alt-PrintScrn)" box on the Client Feedback screen: 

Just hit send and your feedback is on its way!