(November 15, 2011): Last year, the Centers for Medicare and Medicaid Services (CMS) launched their Physician Compare website. CMS's Physician Compare website allows beneficiaries to research their health care providers. The Affordable Care Act (commonly referred to as "Health Care Reform") mandated that CMS launch such a website and that it implement physician performance metrics on the site no later than January 1, 2013.
I. What Will the "Physician Compare" Website Permit?
In theory, the Physician Compare website will serve as an invaluable tool for researching Medicare providers in any locality, even allowing for specific criteria searches such as languages spoken, group practice locations, education history, hospital associations and whether a provider accepts the Medicare-approved amount as payment in full on all claims (obviously patients are still responsible for any copayments and deductibles which might be due). Moreover, by including information from the Physician Quality Reporting System (PQRS),the Physician Comparewebsite has been designed to encourage health care professionals to enhance and improve the quality of care they provide to Medicare beneficiaries.
II. Health Care Providers Have Raised a Number of Concerns Regarding the Physician Compare Website:
Since its inception, the "Physician Compare" website has raised a number of concerns for some health care providers. Clerical mistakes from the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) could be duplicated on the site, resulting in health professionals not showing up in locality searches. It could also result in misinformation about current staff members and incorrect Medicare participation status being listed on the website.
III. Current Status of the Physician Compare Website:
Currently, the Physician Compare website only states whether a physician "successfully participated" in the PQRS, but soon the site will be expanded to include actual performance results from the program, ensuring a higher level of scrutiny in physician evaluations.
IV. Summary:
Why is this important to you? As a health care provider, your reputation is one of the most important aspects of your business. With this in mind, it is more important than ever to maintain a positive image and relationship with both your patients and the government. While you can never completely eliminate mistakes, you can work to reduce the likelihood that mistakes may occur. Compliance initiatives designed to ensure correct information reporting with Medicare, quality documentation and accurate coding and billing serve as an important first step to combating future errors.
Robert W. Liles, Esq., serves as Managing Partner at Liles Parker, Attorneys & Counselors at Law. Robert has extensive experience working with physicians and other health care providers to develop and implement effective Compliance Plans and Programs. Robert can work with and train your staff on coding, billing, documentation and medical necessity issues. Questions? Call Robert today for a free consultation at: 1 (800) 475-1906.