RCM tip of the day: For success under MACRA — clean up physician coding and receivables

CMS has released the final rule for the Medicare Access and CHIP Reauthorization Act. As providers prepare for MACRA, they are looking for ways to successfully navigate the new pay-for-performance model.

Justin Barnes, partner and chief growth officer at iHealth Innovations: Flexibilities built into MACRA mean physicians can stave off first-year Medicare reimbursement losses and potentially earn incentive and bonus payments by partially reporting in the new Quality Payment Program's inaugural year. There won't be a more ideal time for providers to build a strategy for value-based care.

One early-stage MACRA strategy often overlooked is optimizing today's revenue streams to shore up funds that may serve the practice elsewhere. Expert denials and appeals management alone can recover tens of thousands of dollars for practices.

Another area to clean up is physician practice coding. Much of MACRA's quality reporting relies on accurate and complete clinical codes. By cleaning up physicians' coding now, organizations stay ahead of the quality payment curve.

For more on focus areas to help providers successfully navigate MACRA, access this story written by Mr. Barnes.

If you would like to share your RCM best practices, please email Kelly Gooch at kgooch@beckershealthcare.com to be featured in the "RCM tip of the day" series.

 

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