Physician Quality Reporting System

EMPOWERING YOU WITH EXPERT PQRS solutions and CONSULTANTs


The Physician Quality Reporting System (PQRS) is a voluntary quality reporting program that applies a negative payment adjustment to promote the reporting of quality information by individual eligible professionals (EPs) and group practices. The program applies a negative payment adjustment to practices with EPs identified on claims by their individual National Provider Identifier (NPI) and Tax Identification Number (TIN), or group practices participating via the group practice reporting option (GPRO), referred to as PQRS group practices, who do not satisfactorily report data on quality measures for covered Medicare Physician Fee Schedule (MPFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer). Those who report satisfactorily for the 2016 program year will avoid the 2018 PQRS negative payment adjustment. 


Countdown to PQRS Submission Deadline


Submission is the easy part. WE can help you with the hard part. 

In partnership with PQRS Solutions, the industry leader in Medicare quality reporting, we offer comprehensive, user-friendly Submission Dashboard™ and analytical tools to help you achieve PQRS reporting success. With knowledgeable PQRS consultants, you'll have the expert help you need to select a method and measures that are right for you.

  • Select method and measures to optimize performance
  • Repurpose your claims data for PQRS submissions
  • Design a winning submission before it goes to Medicare
  • All with unparalleled customer support

With our comprehensive analytical tools and knowledgeable consultants, PQRS Solutions quality reporting services are trusted by more than 1,000 practices and tens of thousands of providers. We know PQRS better than anyone, and our hands-on, personal touch gives you confidence that your submission is being prepared with the utmost competence and care.

We give you what you require to achieve PQRS submission success: quality reporting tools and all the support you need from experienced Consultants.

MEASURE ANALYZER™
Measure Analyzer™ analyzes your specific practice management data to count patients, visits or episodes of care eligible for each PQRS measure, enabling you to make an informed decision about which measures are most applicable to you.

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INCENTIVE ANALYZER™
Incentive Analyzer™ analyzes your specific practice management data to accurately predict the incentive or penalty that will apply to you. This helps clients prioritize efforts and expenditures.

PERFORMANCE ANALYZER™
Performance Analyzer™ facilitates the creation of performance reports by provider and measure. Its features include the ability to identify low-performing clinical measures that potentially represent patient care gaps or missing data.

PATIENT LIST GENERATOR
Patient List Generator provides you with a list of patient visits that you will need to abstract to generate your qualifying submission based upon the reporting measures you have selected.


CMS Educational Materials

To learn more about 2016 PQRS regulations, access the following documents provided by the Centers for Medicare and Medicaid Services (CMS):

 

Claims Reporting Made Simple
This document describes claims-based reporting and outlines steps that EPs should take prior to participating in 2016 PQRS. It also provides helpful reporting tips for EPs and their billing staff. 


 

2016 Registry Criteria
This document applies to entities interested in participating as a qualified registry in the 2016 PQRS by supporting EPs and/or PQRS group practices. In order to become a qualified registry, entities must meet the definition of a qualified registry, meet all of the requirements, and meet all of the deadlines prior to the due dates listed below.


 

2016 Registry Data Validation Plan Criteria
This document applies to entities interested in participating as a qualified registry in 2016 PQRS by supporting EPs or PQRS group practices. As part of the process to become a qualified registry, entities must submit a data validation plan that meets the criteria set forth by the MPFS Final Rule. This document describes these criteria.


 

Self Nomination User Guide
The 2016 Self-Nomination User Guide helps prospective vendors wishing to participate as a Qualified Clinical Data Registry (QCDR) or Qualified Registry understand how to self-nominate to participate as a vendor for 2016. It addresses the data needed to fully populate and submit a self-nomination.