EDIinsight Integration with the Alpha II CMS-Qualified Registry Enables Your Customers to Effortlessly File PQRS Measures at the Same Time as Claims.

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The PQRS Registry Solution, powered by Alpha II, allows users to effortlessly submit PQRS measures along with claims.

Leveraging the most comprehensive, CMS-qualified Registry available today from Alpha II, The PQRS Registry Solution gives your provider customers a timesaving means of PQRS reporting. It reports measures for both individual EPs (Eligible Professionals) and GPs (Group Practices), and reports on all specialty types and any size group practice. What’s more, rather than simply passing PQRS measures through, The PQRS Registry Solution provides your customers with timely analytic feedback to detect any filing errors. This oversight helps ensure compliance and avoid a potentially costly penalty.

From Incentive-Based to Punitive, PQRS Program Now Has a More Significant Impact on Your Providers’ Revenue.

In 2015 CMS began applying a 1.5% negative payment adjustment to practices that did not satisfactorily report data on quality measures for covered Medicare Physician Fee Schedule (MPFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries in 2013. In 2016, a 2.0% negative payment adjustment was instituted for the 2014 reporting year and beyond. The deadline for 2016 claims to be processed and counted for PQRS reporting to determine the 2018 payment adjustment will be in late February 2017.

Avoiding Negative Payment Adjustments Is a Matter of Integration.

What if filing PQRS measures required no more effort from your provider customers than simply submitting their claims? For your customers who use EDIinsight® Claim Manager and our clearinghouse, that can be the case. By offering them access to The PQRS Registry Solution, claims that are submitted for billing are also checked for PQRS measures. If identified, each claim is analyzed to ensure it is measure compliant and collected for batch submission. Should it be determined that a PQRS measures error is present, the claim is still billed to facilitate timely payment, while the PQRS measure filing is routed to EDIinsight® Task Manager for correction and resubmission.

The PQRS Registry Solution Features:

  • Secure, easy to use, highly customizable Web-based solution
  • Reports all quality metrics for all specialty types and practice sizes
  • Seamless integration with EDIinsight for streamlined reporting
  • Industry-exclusive automated integration of claim and PQRS data
  • Ensures compliance with outcomes and attestation requirements and deadlines
  • Sophisticated, actionable feedback including reporting and performance metrics
  • CMS PQRS Individual and Group Measure Specification Manual compliant
  • Secure, batch uploading of claims to The PQRS Registry Solution
  • Handles and confirms CMS submissions for your provider customers
  • Claim submission workflow is uninterrupted by PQRS filing
  • PQRS analytics and clinical claim scrubbing may be performed simultaneously