Combining MIPS and Charge Capture Leads to Enhanced Patient Care and Revenue

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In the ever-evolving landscape of healthcare, ensuring quality patient care while optimizing revenue streams remains a persistent challenge. Enter the Merit-based Incentive Payment System (MIPS) – an initiative that binds the dual objective of fostering patient care with the economic vitality of healthcare institutions.

What is MIPS?

Created by the Centers for Medicare & Medicaid Services (CMS), MIPS was introduced as a part of the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The core purpose of MIPS is to revamp the way healthcare institutions are paid for services, pivoting from a volume-based model to one that emphasizes quality and value. By focusing on the quality of care, MIPS encourages institutions to prioritize patient well-being over sheer volume with the idea that better care leads to better health outcomes.

Under MIPS, healthcare providers are evaluated on specific performance criteria spanning areas like quality, improvement activities, and promoting interoperability. The aim is twofold – not only to ensure better patient care but also to provide financial incentives (or penalties) to providers based on performance. This commitment is not only ethical but also economical. Improved care can lead to fewer complications, reduced readmissions, and, over time, a more efficient healthcare operation, all contributing to a more streamlined revenue cycle.

Marrying Modern Charge Capture with MIPS

So, where does charge capture fit into this equation? Modern charge capture platforms, such as pMD pCharge™, have evolved to seamlessly integrate MIPS measures. Here are some benefits of using a charge capture solution that includes MIPS:

  • Unified Data Entry: Providers can log charges and capture MIPS data simultaneously, without the need for disjointed systems or repetitive entries. This reduces the chances of oversight or errors, making the process more efficient.
  • Real-Time Reporting: Modern platforms offer real-time MIPS reporting, granting institutions instantaneous insights into their performance. This can assist in proactive decision-making and quick corrective actions, ensuring optimal patient care and maximizing financial incentives.
  • Efficiency and Revenue Augmentation: With an integrated charge capture system, the revenue cycle is expedited. Charges are promptly logged, and MIPS data is instantly available for submission to CMS. Efficient operations invariably lead to better revenue outcomes, with added bonuses from MIPS incentives.
  • Accessibility and Compliance: Platforms like pMD pCharge™ offer cloud-based solutions, ensuring data is accessible, secure, and compliant with regulations. Providers can access the system from anywhere, ensuring constant connectivity and up-to-date MIPS performance metrics.

By ensuring quality care through a modern charge capture solution, healthcare providers can both fulfill their primary ethical duty and position themselves for financial success.

How pMD® Can Help

At pMD®, our mission is to streamline and optimize the patient care episode and the revenue cycle. Through our advanced, end-to-end practice management and revenue cycle solutions, we can help practices consolidate vendors, reduce costs, streamline workflows, improve patient care and satisfaction, and collect their maximum reimbursement more quickly.

Not sure what a vendor could do to improve your behavioral health billing? Contact pMD® for a no-commitment financial impact analysis by our team of healthcare RCM experts free of charge!

To find out more about pMD's suite of products, which includes our charge capture and MIPS registry, billing services, telehealth, and secure communication software and services, please contact pMD.

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