This is the first post in my “In The KNOW series”
In this episode we look at the CMS 126v4 measure- Use of Appropriate Medications for Asthma for the Attestation year – 2017 for eligible EPs.
As per CMS FINAL Rule in October 2016- this above measure has been permanently removed from the 2017 MIPS reporting. This decision was made based on high performance numbers and resulting minimal variation in care.
Have you looked at your MU2/3 dashboard in Practice Fusion and noticed that the percentage or # of patients for the ECQM measure: Preventative care screening: for High Bloodpressure and floww up documented; is zero?
Don’t panic! On Oct 26th, 2017 Practice Fusion updated their EMR and the dashboard so it affected this ECQM.
According, to PF reps, this has been reported by at least 9 other providers and is being addressed.
Taking in consideration that your office and you, have been following the suggested workflow to capture this measure, in PF EMR, you should continue this process until the issue will be resolved and you start seeing the # and percentage for the measure again.
Now it’s your turn: have you seen any other ECQM measure being affected by the October update?
UPDATE: 12/19/2017- the issue has been resolved. Your MU dashboard should show you the correct percentage now.
Recently, I had a situation in an office of an allergy/immunologist – regarding a denial of the medication (that requires prior authorization), because of a failure to double check the spelling of medications; during a verbal prior authorization request. Please note that both medications did sound the same, however were two completely different medications. In thi situation, neither the prior authorization rep or the office manager asked for a spelling of the medication. Result: denial of the medication.
Remember medications requiring prior auth need to meet the medical policy standards (medical necessity), for that specific medication or you will receive a denial.
This is why I love to do an online authorization request instead. Once you fill out all the needed clinical questions and upload the needed medical notes, there is no confusion regarding which medications the patient is taking and how they are spelled or pronounced.
Investing in a scanner, for your office, is a great idea!
Now its your turn: have you used online prior authorization tool? Does your office have a scanner to scan documents?
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