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PQRS 2014 – Incentives or Adjustments – Your choice?

May 29th 2014 at 12:03 AM

Medicare proposed the Physician Quality Reporting System (PQRS) after several physician payment models like the fee-for-service and episode-based payment failed to report quality measures accurately. This program allows eligible professionals to report quality information so that they can enjoy incentives. It also applies payment adjustments if eligible professionals fail to report quality measures for the medical services they render. With 2014 set as the deadline, Providers are facing a tough time implementing the PQRS system while handling medical billing and collections. Outsourcing a part of physician medical billing services may help reduce the burden considerably. Let us take a look at how physicians can make the most of the PQRS payment model:

Learning the PQRS Deadlines:

· 12-month PQRS Data Collection: This data collection period has already started on Jan 1, 2014 and will continue through December, 2014. Physicians will be expected to follow PQRS reporting to avoid a penalty of 2.0% in 2016. Providers can get help from outsourced medical billing companies for uninterrupted quality reporting.

· PQRS Group Registration: Effective from April 1, 2014, group practices were given the option of self-nominating and selecting their preferred reporting options. The registry reporting mechanism, Group Practice Reporting Option (GPRO) web interface, and the CMS-calculated administrative claims reporting method are the different reporting options. Recently, the deadline has been extended to Oct 18, 2014 by CMS.

· 6-month PQRS Data Collection: Starting July 1, 2014, this data collection period will continue through December 31, 2014, providing a 0.5% bonus. It is applicable only to eligible professionals who report quality measures through qualified registry. By outsourcing physician medical billing services, Providers can save money and time while enjoying the incentives provided by the PQRS system.

Incentives and Payment Adjustments:

· Providers must understand the fact that participating in PQRS 2014 will also determine payment adjustments done in 2015 and 2016.

· Eligible professionals, who implement PQRS in their practice and report quality measures for covered professional services will enjoy a bonus of 0.5%.

· A 1.5% deduction will be applied in 2015, if Providers fail to report quality measures for the medical services rendered.

· A 2.0% deduction will be applied in 2016, if Providers fail to report quality measures for the medical services rendered.

· The decision lies with Providers whether to choose incentives or payment adjustments. However, it is advisable that they make the most of the PQRS by implementing it in 2014.

While doing so, they can get help from outsourced medical billing companies for uninterrupted medical billing and collections. One of the reputed and highly reliable physician medical billing services providing company is MGSI.

About MGSI:

For exceptional physician medical billing services, rely on MGSI, a Florida-based, national outsourced medical billing company. With more than 20 years of experience in the healthcare domain, MGSI will take care of all the medical billing and collections requirements, while Providers implement PQRS into their practice to avoid payment adjustments. To learn more details, log on to

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