CMS Quality Report Tools for Medical Billers

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Description

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#1001V3

Data Extraction Toolkit - Billing Companies and Providers share the same problem – most software limits the ability to export information.  Either HER vendors lock-in their customers by limiting the ability to export information to another supplier or vendors charge outrageous prices for simple export functions. CMS gateways offers the Data Extraction Toolkit (aka Data Hostage Mitigator) which include applications and instructions to successfully export, format and crosswalk important provider and patient related data from .EHRs. 

Description, fees and delivery processes

(1)     Phase 1: Free evaluation

(a)     Describes Windows system processes for export

(i)       Print to file - raw text data (XP, Windows 7, 8, Surface)

(b)     Requires registration - online form

(i)       Email address verification registration

(1)     Registered software installation

(a)     Cost of license

(i)       Standard: $100 / Installation

(ii)     Professional: $250.00 / Installation

(b)     Includes extended export and formatting capabilities

(i)       Custom printer driver for optimum export capabilities

(ii)     De-identification utilities

(iii)    Data mapping utilities

(c)     Requires Account activation by Medical Biller

(d)     Online registration form

Item
#2003V2

Optima Measure Selector - With CMS tripling the 2015 measure reporting requirements, EPs must choose the optimal panel of measures and associated workflow to support a successful PQRS submission.  To build the capacity of Medical Billers to meet these new demands, CMS Gateways created the Optima Measure Selector.  This tool enables Medical Billers to re-purpose client billing records by using historical claims to map their patient panel to CMS measures and domains.  This process enables your clients to prospectively choose their 2015 measures and to selectively code this subset of claims for CMS submission.  This tool was designed to assist practices in 2015 when nine measures must be selected and submitted across three NQS domains.
 

Description, fees and service delivery processes

1)        

Phase 1: Free evaluation

a.       Uses de-identified CMS-1500 information

(i)       Online exchange of files

b.       Requires registration - online form

(i)       Email address verification registration

Phase 2: Create a Registered EP account

a.       $50/NPI

b.       Requires Account activation by Medical Biller

(i)        Required for ‘live’ data’

(ii)      Online registration forms

1.       BAA – Business Associate Agreement

2.       NDA – Non-disclosure agreement

Item
#2004V3

PQRS QRDA Toolkit - Billing Companies have successfully used the 'Claims' workflow process to integrate PQRS Quality Codes (QDC) for many years.  Unfortunately, CMS begins de-commisioning the 'Claims' PQRS process in 2015.  

To prepare for new PQRS processes, CMS Gateways has created tools that empower medical billers to implement a streamlined procedure like 'Claims' that integrates clinical data into the existing PQRS workflow.

PQRS sans EHR - Given the fact that many EPs (Therapists: OT/PT/Audio) don’t have an EHR; Billing Companies can use  the PQRS QRDA Toolkit to streamline the PQRS workflow. 

PQRS sans .EHR support - Given the fact that many practices have an EHR that does not support 2015 PQRS requirements; Billing Companies can use PQRS QRDA Toolkit to streamline the PQRS workflow. 

a)       Free evaluation

i)         Requires registration - online form

(1)     Email address verification registration

b)       Registered EP account

i)         Billed per NPI / TIN

ii)       Requires Account activation - Medical Biller

(1)     Required for ‘live’ data’

(2)     Online registration form

(a)     BAA – Business Associate Agreement

(b)     NDA – Non-disclosure agreement

c)       Licensed software

i)         > 50 EPs

(1)     Internalized Medical provider workflow

ii)       Custom installation

(1)     Large user (over 1000 EPs)Streamlined report integration into workflow