VersaForm General FAQ
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2014 PQRS Incentives and Penalties

New in November 2014

If you are using claims-based reporting Medicare is now requiring that you include a $0.01 line-item charge for the quality-data code. Previously you could use $0.00.

Important Information for 2014

Providers successfully reporting Physician Quality Reporting System (PQRS) Codes in 2014 will receive a 0.5% incentive in 2015.

A Medicare provider who is not reporting PQRS codes in 2014 will receive a 2% penalty in 2016. To avoid this penalty there are options for Individual Eligible Professionals. The clinic should review which option best fits the practice.

Options for Reporting:

Claim Based Reporting

  • Individual Measure
  • At least 9 Measure Codes selected from three NQS (National Quality Strategy) which is tied to Meaningful Use criteria.
  • Report the nine measure codes for at least 50% of applicable Medicare Part B patients. 
  • This is between 01/01/2014-12/31/2014.

Group of Codes Measure

This option has been DISCONTINUED in 2014

Registry Based Reporting - (Office Administrator Involved)

In Spring 2014, CMS will have a list of Registry Vendors available on their website to allow providers to select as an option for reporting service.

  • Individual Measure
  • At least 9 Measure Codes selected from three NQS (National Quality Strategy) which is tied to Meaningful Use criteria.
  • Report the nine measure codes for at least 50% of applicable Medicare Part B patients. 
  • This is between 01/01/2014-12/31/2014.

Group Measure

  • One Measure Group for 20 unique applicable Medicare Part B patients.
  • This is between 01/01/2014-12/31/2014

EMR Based Reporting - (contact your EMR Vendor)

  • Individual Measure
  • At least 9 Measure Codes for 50% of applicable Medicare Part B patients.
  • Report on 3 MEDICARE EHR Incentive Programs Core measures.  
  • Report on 3 (of the 38) additional measures available for the MEDICARE EHR Incentive Programs.

Through a Portal – Administrative Claims-based Reporting

The ability to submit claims online has been DISCONTINUED in 2014

As you can see, PQRS can be quite complex. For help, or further information on this or other medical billing matters, please contact us.

Magnifying Some VersaForm Windows

Do you ever want to get a "closer look" in VersaForm? Try clicking in the window you want to magnify and then, while holding down a Ctrl key, move the scroll wheel on your mouse. Up gets bigger and down gets smaller.

How to Use the CMS-1500 (02-12)

You have two options, depending on whether more of your insurance plans will continue to use the 08/05 form or will switch to the 02/12.

Availity's EDI Clearinghouse Services are Changing-OR, WA & IL

Beginning on January 18, 2014, Availity will no longer send government and non-participating payer claims at no cost and the fees for those claims will be charged to VersaForm. We will then need to pass those fees on to the submitters.