Wednesday, Feb. 20, 2013
Practice News
Avoid contracting traps: Insurer dispute resolution
An AMA webinar at 1 p.m. Eastern time Feb. 26 will explain what physicians need to look for in their managed care contracts to ensure a fair dispute resolution process, should conflicts occur in the future. Register today.
Part of a series on managed care contracting in an evolving health care environment, this webinar will help physicians understand common non-litigation dispute resolution mechanisms and what to watch out for in managed care contracts.
An experienced health law attorney will explain how alternative dispute resolution mechanisms compare to litigation, how to avoid traps in contract clauses and which mechanisms physicians have found most helpful in resolving disputes with insurers.
Visit the AMA Practice Management Center to access archived webinars that can help physicians negotiate fair contracts and navigate relationships with health insurers.
Avoid 2015 payment penalty: Participate in 2013 PQRS
Most physicians likely will see a 1.5 percent reduction in their 2015 Medicare payments unless they start meeting quality reporting requirements this year. Resources are available to help.
To avoid the 2015 penalty, physicians must satisfy the 2013 requirements for the Medicare Physician Quality and Reporting System (PQRS). A number of reporting options are possible for physicians as individuals or group practices, including paper claims, registries and electronic health records.
Thanks to recommendations made by the AMA to the Centers for Medicare & Medicaid Services (CMS), two simplified reporting options are available for physicians who wish to avoid the 2015 penalty: reporting only a single measure or measure group and reporting via administrative claims.
Under the second option, physicians do not need to report special codes. Instead, CMS will analyze their claims data to determine whether they have met the quality requirements. Physicians and group practices who choose this option must sign up to do so by Oct. 15.
Visit the AMA's PQRS Web page and read a recent article in American Medical News to learn more.
In addition, a new set of participation tools from the AMA-convened Physician Consortium for Performance Improvement® offers worksheets to help physicians understand dozens of individual quality measures and measures groups that are part of the PQRS. The worksheets also aid physicians in collecting the appropriate information they need to report.
