Relieve the stress of PQRS and avoid the

penalty with The PQRS Registry Solution,

powered by Alpha II & integrated with

EDIinsightSM. Seamlessly integrated with

the EDIinsight workfl ow, The PQRS Registry

Solution reports PQRS measures for both

individual EPs (Eligible Professionals) and GPs

(Group Practices). It also reports on all specialty

types and any size group practice. But, what

truly diff erentiates The PQRS Registry Solution

is its ease of use thanks to tight integration with

EDIinsight and our clearinghouse.

File PQRS measures at the same time you submit claims with no extra eff ort through EDIinsightSM integration with the most comprehensive, CMS-qualifi ed, Registry available.

The PQRS Registry Solution

If you use EDIinsightSM Claim Manager and our clearinghouse to submit claims, you can opt to file PQRS measures at the same time you submit claims without any additional steps. Claims that contain PQRS measures are automatically identified and analyzed to ensure each is measure compliant. The PQRS Registry Solution functions similarly to EDIinsightSM Clinical Claim Scrubbing in that it flags claims that are not ready for submission; however, since PQRS measure errors are not something that prevent payment, you are simply informed that the PQRS measure wasn’t satisfied, but the claim is sent to the payer anyway. You can then use EDIinsightSM Task Manager to readily facilitate PQRS measure correction and resubmission to the registry without changing the status of the claim in adjudication or increasing AR days.

You Get What You Pay ForUnlike the free PQRS registries that may not report all measures and perform only the basic registry function, The PQRS Registry Solution gives you near real-time analytic feedback to detect any filing errors. It also shows exactly where issues exist and offers an easy to use interface where you may fix them prior to submission to help ensure you don’t get penalized.

Failure to Report Can Be CostlyPQRS has transitioned from an incentive-based program to a punitive one for practices that do not satisfactorily report data on quality measures for covered Medicare Physician Fee Schedule (MPFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries. In 2015, the program began applying a negative payment adjustment to EPs and GPs that did not satisfactorily report quality measures data in 2013. Those who report satisfactorily for the 2016 program year will avoid the 2018 PQRS negative payment adjustment.

Reporting Year Payment Year PQRS Negative Adjustment Group Size

2013 2015 -1.5% 100+ EPs

2014 2016 -2% 10+ EPs

2015 2017 -2% All EPs

2016 2018 -2% All EPs

Timeline for 2016 PQRS ReportingThe deadline for 2016 claims to be processed and counted for PQRS reporting to determine the 2018 payment adjustment will be in late February 2017.

2016 Reporting Avoid 2018 Penalty

INDIVIDUAL PROVIDERS

Individual Measures Report on at least 9 individual measures covering 3 NQS domains for at least 50% of denominator eligible Medicare Part B FFS patients. An EP that sees at least 1 Medicare patient in a face-to-face encounter must report a minimum of 1 cross-cutting measure.

Group Measures Report on all applicable measures within the selected measures group for a minimum sample of 20 unique patients, a majority of which (at least 11 out of 20) must be Medicare Part B FFS patients.

GROUP PRACTICE REPORTING OPTION (GPRO)

Individual Measures Report on at least 9 individual measures covering 3 NQS domains for at least 50% of denominator eligible Medicare Part B FFS patients.

EPs wanting to satisfactorily report 2016 PQRS data and avoid the 2018 negative payment adjustment, must meet one of the above criteria.

The PQRS Registry Solution is an interactive tool that provides constant updates and immediate feedback on reporting and performance rates.

FEATURES• Secure, Web-based solution that is easy to use and highly customizable

• Enhanced reporting on all quality metrics for all specialty types and practice sizes

• Integrated to work seamlessly with EDIinsight to streamline the reporting process

• Industry-exclusive automated integration of PQRS data with claim data for easy submission

• Designed to help ensure outcomes and attestation requirements and deadlines are met

• Provides timely reporting and performance metrics for sophisticated, actionable feedback

• Compliant with requirements outlined in the CMS PQRS Individual and Group Measure Specification Manual

• Secure, batch uploading of claims to The PQRS Registry Solution

• All submissions to CMS are handled on your behalf with confirmation of receipt

• User workflow is not interrupted by PQRS filing

• PQRS analytics and Clinical Claim Scrubbing may be performed simultaneously and results may be consolidated or returned separately

• Claims that pass Clinical Claim Scrubbing edits but fail PQRS analytics are billed and PQRS edits are routed to EDIinsight Task Manager for correction and resubmission

phone: 713.333.6000 fax: 713.333.6006 email: info@practiceinsight.netPractice Insight, LLC One Greenway Plaza, Suite 350, Houston, Texas 77046www.practiceinsight.net © 2015-2016 Practice Insight, LLC. All rights reserved.

4/2016

Get PQRS Compliant ASAPPQRS measurement options and reporting guidelines can be overwhelming. The PQRS Registry Solution can help your practice remain PQRS compliant and avoid negative payment adjustments from CMS. Let our team of experts streamline the process for you.