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FOR IMMEDIATE RELEASE
July 11, 2007Alpha II Claimstaker integrates Physician Quality Reporting
Initiative (PQRI) Edits
Claims editing software helps doctors meet national pay-for-performance standards
and receive an additional 1.5% in Medicare reimbursementTALLAHASSEE, Fla. – July 11, 2007 – Alpha II, the software leader in healthcare coding, compliance and claims editing announced the integration of physician quality reporting measures into ClaimStaker, the claims editing solution in Alpha II's suite of applications and developer toolkits. As a part of the regular claims scrub process, ClaimStaker now checks the coding and reporting for any of the 74 measures in the Physician Quality Reporting Initiative (PQRI) on which the physician has decided to report.
Physicians will likely select to report on only a few measures based on their practice specialty and patient population. For their effort, the Centers for Medicare and Medicaid Services (CMS) established a financial incentive for physicians who elect to participate in this voluntary program. To receive the 1.5% incentive payment, a performance measure code and/or modifier must be reported on at least 80 percent of the physician’s claims on which the specific measure’s clinical condition is represented by use of the condition’s ICD-9 diagnosis code. The PQRI reporting project is applicable for Medicare services rendered between July 1st and December 31st of this year.
“In a time of declining Medicare reimbursements, healthcare providers have a significant opportunity to boost revenue by including PQRI reporting in the routine workflow,” says Marla Harmon, product manager of ClaimStaker. “Reporting and incentive payments require the use of a National Provider Identifier (NPI), so even individual physicians within a group practice may elect to participate. Depending on the size of the organization, some of our medical practices may be able to recoup an additional $10,000 to $20,000, while others could see reimbursements upwards of $100,000. By using ClaimStaker to assist with proper reporting, a physician practice may also find it feasible to participate in a larger number of PQRI measures.”
About Alpha II
The Alpha II technology solutions support coding, compliance, claims editing and revenue analysis for more than 30,000 healthcare professionals at medical practices, hospitals and health systems, clinics, billing services, outpatient facilities and other healthcare organizations, both commercial and governmental. More than 30 developer partners trust Alpha II solutions to enhance their practice management, electronic medical record (EMR) and other healthcare information systems. For additional information, visit Alpha II on the Web at www.alphaII.com.
Press contact information:
Dave Anderson, Dodge Communications, 770-998-0500 ext. 229
danderson@dodgecommunications.comJan Powell, MEGAS Corporation, 850-668-3922
jpowell@megas.net
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