Louisville, KY – December 20, 2012
ZirMed, a leading provider of revenue cycle and information solutions for healthcare, today announced the update to their 2013 Physician Quality Reporting System (PQRS) solution. ZirMed’s industry-acclaimed Claims Management Suite offers providers a PQRS suggested measures report and the ability to submit individual patient quality data to Centers for Medicare & Medicaid Services (CMS) with confidence for their 2013 Medicare Part B – 0.5% incentive payment.
In 2007, CMS took its first step towards pay for performance reimbursements by launching the Physician Quality Reporting Initiative (PQRI). Since its introduction, CMS has paid bonus payments to the hundreds of thousands of providers who have begun reporting information used to evaluate patient outcomes and assess the quality of care delivered.
“ZirMed continuously seeks to identify and develop innovative solutions for our customers. Our PQRS tool is just an example of ways that we differentiate ourselves from our competitors by offering health care providers solutions to improve their business workflows and revenues so they can focus on their primary goal, delivering quality patient care.” says Tom Butts, CEO at ZirMed.
ZirMed’s PQRS Suggested Measures is a valuable report that can be requested by users of the Claims Management solution. In the report, historic patient claims data is analyzed for an individual provider to determine which CMS quality measure codes are most relevant for their practice. This level of specificity and frequency allows healthcare providers to understand their patient demographics, choose the quality codes that best fit their practice, and structure a quality measuring and reporting program.
ZirMed’s PQRS Monitoring solution will scrub outgoing Medicare claims and alert the submitter each time quality measures are not reported, and will return the claims to the provider for additional information. Flagging the claim and returning it to the provider is a critical precautionary step in maintaining compliance with the 50% reporting requirement against quality measures for qualified Medicare claims. ZirMed’s smart coding tool offers providers the comfort of knowing an inspection instrument will review each Medicare claim before it is submitted, not only to receive the 0.5% incentive payment, but to improve the reporting and practice of quality of care medicine as well. “I look back now and see how much time we are saving and can’t believe it. Using ZirMed is one of those things where once you have done it, you wish you would have done it sooner.” Says Laurie Emerson, Billing Department at Functional Kids Clinic.
To qualify for the bonus, providers must report on at least 3 PQRS measures and include PQRS quality data on 50% of the claims that qualify for each measure. Currently, the PQRS bonus payments are based exclusively on participation and successful reporting rather than on the performance indicated by the PQRS measures. Even if a provider reports a negative outcome for each qualifying patient, he or she will still earn the participation bonus if quality data has been submitted on at least 50% of the qualifying claims. Therefore, it is the act of reporting itself, and not the quality of care indicated by the reporting, that determines whether a provider will meet the requirements for earning the PQRS bonus.
Those providers who do not participate in 2013, will not only miss out on incentive payments, but will incur penalties starting in 2015.
ZirMed is a nationally recognized leader in delivering revenue cycle management solutions, serving more than 120,000 healthcare providers. ZirMed leverages the power of technology to cure administrative burdens and increase cash flow, enabling providers to not just survive but thrive. ZirMed solutions include eligibility verification, credit/debit card processing, check processing, claims management, coding compliancy and reimbursement management, electronic remittance advice, patient statements, patient e-commerce solutions, and lockbox services. ZirMed is rated amongst the top in KLAS, and has been a multi-year recipient of Inc. magazine’s 500/5000 fastest growing companies and Healthcare Informatics magazine’s Top 100 Companies awards. For more information about ZirMed, visit www.Zirmed.com.