tci Part B Insider - 2007 Issue 23

PQRI: Some Clearinghouses Are Muddying The PQRI Waters

Talk to your vendors, save your bonusWarning: Some clearinghouses may be sabotaging your efforts to obtain the 1.5-percent bonus in the Physician Quality Reporting Initiative (PQRI). The Centers for Medicare & Medicaid Services (CMS) sounded the alarm that some clearinghouses are stripping the National Provider Identifier (NPI) from claims before sending them to Medicare. CMS isn't yet denying claims that lack an NPI--but claims without NPIs won't count toward the PQRI.PQRI basics: You have to report on your chosen quality measures at least 80 percent of the time that they apply. Where applicable, you should have one...

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