report mips 2019 and beyond...mips measure calculator. 02/12/20 property of ics software, ltd. 6 the...

MIPS 2019 and Beyond …

02/12/20 Property of ICS Software, Ltd. 1

Host: Barbara Buffolino

Getting Ready to Report MIPS 2019And Beyond …

Disclaimer

It is our pleasure to interpret all of the rules, requirements, due dates, etc. having to do with Billing, MIPS and HIPAA. However, you should know that it is your responsibility to know and understand all of the rules, requirements, due dates, etc. Most of this information is on SammyUniversity.com and in the FAQ (help.icssoftware.net) and taking information strictly based on verbal communication is not recommended.

202/12/20 Property of ICS Software, Ltd.

Topics to be reviewed

COMPLETING MIPS 2019 REGISTRATION Deadline to Register and Report

ELIGIBLE TO REPORT? If not, What is Opt In?

MIPS Measure Report REVIEW If SammyUSA or SimpleSam: How to fix manual reporting?

Changes for MIPS 2020 Reporting

Reports to Calculate the Incentive $$ Received


1. At this time, most providers should know if they are required to report MIPS but if you are still not sure access the website www.qpp.cms.gov to double check your participation status by entering your NPI #.

2. NEW THIS YEAR! You can decide to OPT-IN to report your MIPS data if you do not meet all the participation criteria.• You will see this opt-in status when you check your NPI number

in www.qpp.cms.gov• You will also be alerted that you are a candidate to Opt-in after

you register and run the measure calculator. A status will be displayed in the bottom right corner of the measure calculator.


Are you required to report this year?

If not:

Are you able to Opt-In?

http://www.qpp.cms.gov/

http://www.qpp.cms.gov/

Deadline to register and upload the data is:February 29, 2020.

Registration for MIPS registry can be accessed from multiple areas of Sammy:

Click Utilities and then the Account Management option.

When running the Measure calculator click the Account Management button located at the bottom of the screen.

When registering you need to make sure to pay the fee and sign the electronic Consent Form and business associate agreement (if not signed in previous years).

Deadline for Registration

and MIPS 2019 Reporting


How to run the MIPS Measure Calculator


The Measure Calculator can be accessed by logging into Sammy and click on the option called Utilities.

Scroll down and click on the option MIPS Measure Report.

Make sure you are running the latest version: MIPS Calculator (V1.7.0.108)

NOTE: If not, please process a measure calculator update.

The providers in the practice will be displayed along with Registry account status. All eligible providers must be registered to display the status of Registered.

MIPSMeasure Report

For 2019 you will report on the Quality and Practice Improvement components for MIPS.

All practices were directed to submit a Small Practice Exception application in place of reporting Promoting Interoperability.You are still required to have an updated HIPAA manual

which should contain a Risk Analysis for the Practice.Reporting period is for the full year of 2019.Once a provider is registered the projected score will be

displayed. Your final score will be determined by CMS and will provided to you in the CMS feedback report.Neutral reporting (no penalty/bonus) can be accomplished

with any component reporting at 30% and above. (The Cost component does not count toward this 30%).


Running the MIPSMeasure Calculator


The first screen will display all the providers that billed Medicare claims and their status with the registry for either individual or group.

When you choose a provider press the continue button to have the MIPS detail screen display the current status of the Quality measures and the attestation for the Improvement Activities.

The bottom right hand corner will display the status of the account. The next slide explains the different status that may be displayed.


Account status:In the bottom right hand corner of the report you may see different statuses:

Create Provider and/or Pay: you need to setup and pay for the registry for this provider.Missing Consent: there is an electronic signature missing when the registry account was set up. Click on the link to sign the document.Ready to Upload: you are ready to upload your data. Click on the Submit Data To Registry to upload the data.Locked for Submission: you did your final upload to the registry and you are done for 2019 reporting.Opt In Decision: you are not required to upload for MIPS 2019 but can decide to Opt In. Please see separate slide for more information.

Steps to Upload:


1. Attest for Improvement Activities. Choose either 1 High or 2 Medium choices.

2. The Expected Score will be displayed at the bottom of the screen. The final score will be determined by CMS.

3. When you click the Submit to Registry button you will be asked if all your 2019 claims have been entered? Did you file the Small Practice Hardship application?

• If yes, you will prompted to enter the Hardship Exception ID found in the email from QPP.

• If no, you will still be able to upload but we are not sure how this will impact your final score.

Improvement Activities: For our EHR clients we do suggest the first choice if you have remote access to patient notes and you do notes for patients you speak or treat after normal office hours.Otherwise you will need to choose 2 Medium choices. Please access the FAQ with keyword Practice Improvements for suggested choices.


What does it mean to Opt In?

Opt In is a QPP/ CMS process to allow providers who recorded MIPS data but didn’t meet all the required criteria to upload data anyway. After CMS evaluates your data you may be eligible for a “mini” bonus.

While Opt-In is appealing for a possible “mini” bonus, you will also open yourselfup to an audit of your data by CMS when your not required to. Up to you!

You definitely should NOT Opt In:1) if your projected score is close or below 30% or 2) if you did not fill out the Small Practice Hardship application. Not sure how this will impact your final score.

The penalty amount can be calculated up to 7%.

An Opt In status will be displayed in two places:• If you check your

participation status at the website www.qqp.cms.gov you will see the Opt In status if you do not meet the MIPS criteria.

• If you registered to upload MIPS but you are not required to report, we will display the Opt In status in the bottom right hand corner of the report.

http://www.qqp.cms.gov/

If You Decide To Opt In!


After clicking the link Opt In Decision click on Circle #3.

Select the type of Opt In you want to participate in:

1. Opt In (Payment Adjustment)Your data will be evaluated for a Payment adjustment .

2. Voluntarily Report (No PaymentAdjustment) You decided to upload only for feedback no payment adjustment.

Check the pink box that statesyou can not change your mind oncesubmitted. Click Submit or Back if you change your mind.

Sammy USA and SimpleSam or

Non-DPM providersManually Reporting


The recording of your MIPSis manual which means at the time of billing claims you neededto select the measures and thereporting codes that you wantedto record.

https://help.icssoftware.net/28735-mips/364613-mips-measurebot-and-registry-upload-2019-sammyusa-simplesam

Because you are manually choosing codes it is possible that the wrong codes were chosen causing errors after you upload.

After you upload, if necessary you will be able to fix the codes that are creating the errors.

Directions to fix the reporting codes can be found in the Sammy FAQ under the section labelled MIPS. Or access the link found below:

https://help.icssoftware.net/28735-mips/364613-mips-measurebot-and-registry-upload-2019-sammyusa-simplesam

What’s NEW for MIPS 2020


We are advising clients to continue recording information for the MIPS measures that they did in 2019 with one exception:• Measure 109 – Osteoarthritis has been ELIMINATED.

As of right now the requirements are to report on 6 Quality Measures but as always we recommend you work on recording extra measures.

MEX Measures We recommend that providers include the Podiatry

oriented MEX measures. The MEX measures can be met by the provider simply doing notes with the appropriate DX codes, pain scale and other requirements. You can review the criteria for these measures by searching the FAQ with keyword MEX.

How Much Incentive $$ Did I Receive?


Run the Financial A Report Run the Financial C Report Run the Report Generator

Report In the claim history, each

claim will display any incentive money received and posted.

Incentive adjustments willalso be displayed on Medicare ERAs with the codeCO-144.

Financial A

Financial C

Report Generator

Claim History

Thank you


Thank you for attending our webinar!

Please contact us with any questions you have:

Support: 516-766-2129

[email protected]

mailto:[email protected]

report mips 2019 and beyond...mips measure calculator. 02/12/20 property of ics software, ltd. 6 the...

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