Important dates

November 22nd, 2019

Dates to mind

December 31st, 2019
MIPS exception/exemption deadline for 2019 data – move 25 points from Interoperability to Quality.

January 1st, 2020
Clinical decision support mechanism (CDSM) required for all imaging orders. Providers must use a qualified CDSM program.

Walmart requires electronic prescribing of controlled substances (EPCS). Other states will follow this behavior.

January 2nd, 2020
MIPS 2019 data submission window is open.

January 14th, 2020
Microsoft discontinues support for all Windows 7 and Windows Server 2008 operating systems. 

March 31, 2020
MIPS 2019 data submission window is closed

January 1st, 2021
Medicare requires EPCS for Part D. 

All dates are subject to change, as we know from past experience, but be alert and ready.

Posted by Jim Sherrill | Topic: News  | Category: News

Bit of a breather for MIPS

September 24th, 2019

2019 MIPS exemption!

For small (<15 "Eligible Clinicians") practices, you may choose to exempt from Promoting Interoperability (PI, or Meaningful Use) and move those 25 points to Quality measures for 2019. 

The hardship exception application is simple:

MIPS > Reporting > Reporting Factors Overview > Exception Applications

Click Apply in the "PI Hardship Exception Application Window is Now Open" green-backgrounded rectangle.

Choose Group or Individual, then complete the rest of the fields. Then, rather quickly for a huge government program, the provider should receive an e-mail confirmation of your approved application. Boom, now your existing Quality efforts through 2019 are now providing you more bang! 

Posted by Jim Sherrill | Topic: News  | Category: News

Patient payments

September 21st, 2019

Get paid!

Another value-added reseller recently advised us that some practices are using Papaya for patients to pay them quickly. 

This service lets patients install an application on their phone, scan their printed statement, then pay immediately via the application. Now that is not perfect, because it implies that you have generated & sent a statement, i.e. spent time and money, but it is an attractive alternative. Have a online statement process for patients? No problem, the patient can import that statement image into the application. Papaya is an EASY way for patients to pay you. 

This is a nice use of technology: Papaya recognizes the scanned statement elements, processes the payment, and sends the money to you. Your mileage may vary, we have not used this process and dragons may dwell nearby, so caveat emptor as always! Best wishes for speedy payments.

Posted by Jim Sherrill | Topic: Tips  | Category: News

History Time

September 7th, 2018

Battle of Chickamauga, 155th Anniversary


If you are interested in the massive and awful battle, there are many programs at the Chickamauga and Chattanooga National Military Park this month.

Please have a look and participate if you are able!

Posted by Jim Sherrill | Topic: News  | Category: News

MIPS Overview

December 1st, 2016

It's time for more changes in how providers navigate Medicare payments, welcome to MACRA and MIPS. MIPS consolidates and changes the MU, PQRS, and VBM programs. Here are the more tedious program names from these acronyms: Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) -- Notice the clever nested acronym: Children's Health Insurance Program (CHIP) --, Merit-based Incentive Payment System (MIPS), Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-Based Payment Modifier (VBM). The stated intent of these revised government programs is to achieve the "Triple Aim" of higher quality, lower spending, and better patient outcomes.

We will continue to add content as these programs develop and our products evolve to meet the new requirements. MACRA is 2,171 pages, so some of this information may change. Let's take a sip from the MIPS firehose now:

  • Each provider will receive a MIPS Score from 0 to 100
  • MIPS scores will be public and recalculated each year
  • Scores determine providers' yearly Bonus or Penalty

Four MIPS Performance Categories, for 2017 (percentages shift in 2018 and beyond)
Quality - 60%
Advancing Care Information - 25%
Clinical Practice Improvement Activities - 15%
Resource Use - 0%, but will be weighted and used for 2018 and beyond

Four MIPS Participation Options, for 2017
    No participation: Organizations not exempt from MIPS that do not send in any 2017 data will receive a negative 4% payment adjustment.
    Report one measure for a minimum 90-day period: One Quality, ACI, or CPIA measure will earn enough MIPS points (3 points, yes three, is the no-penalty threshold) to avoid a penalty and possibly earn a small incentive.
    Report more than one measure for a minimum 90-day period: More than one measure in any or all of the Quality, ACI, or CPIA categories avoids a penalty, maximizes the MIPS score, and potentially earns the highest possible incentive.
    Participate in an Advanced Alternative Payment Models (APM): Organizations that sufficiently participate through an Advanced APM earn a 5% Part B bonus and are exempt from MIPS.

Who is Eligible for MIPS
Physician assistant
Nurse practitioner
Clinical nurse specialist
Certified registered nurse anesthetist

In 2019 and beyond, these providers are added for MIPS:

Physical and Occupational Therapists
Speech-language Pathologists
Nurse Midwives
Clinical Social Workers
Clinical Psychologists
Dietitians/Nutritional Professionals

Who is Exempt from MIPS
First-year Medicare providers
Providers with a low volume of Medicare patients (less than $30,000 Medicare Part B or less than 100 Medicare patients)
Qualifying participants in eligible APM.Possibly exempt: Rural health clinics or Federally Qualified Health Clinics (FQHCs)

How do I know if I'm ready to participate in MIPS?

  1. Check that your electronic health record is certified by the Office of the National Coordinator for Health Information Technology. If it is, it should be ready to capture information for the MIPS Advancing Care Information category and certain measures for the Quality category.
  2. Consider using a qualified clinical data registry or a registry to extract and submit your quality data.
  3. Use the websites below to explore the MIPS data your practice can choose to send in. Check to see which measures and activities best fit your practice.

Where to learn more


Posted by Jim Sherrill | Topic: News  | Category: News

Careful thought

February 2nd, 2016

We humans are a bit quick on our pattern seeking and story telling:

Placebo-controlled, double-blind studies with replicable significant results remain the Gold Standard of science.


Posted by Jim Sherrill | Topic: News  | Category: News


October 7th, 2015

Latest revisions to Meaningful Use rules are now out, here are some first pass highlights:

  • Reporting periods for 2015 are any continuous 90-day period in the 2015 calendar year - instead of calendar-quarters. 
  • Attestations for the 2015 reporting period can be submitted to  CMS's portal from January 4 - February 29, 2016.
  • For 2015 and 2016 reporting periods, the View, Download, Transmit component of the Patient Electronic Access objective now requires that only one (1) patient view, download or transmit their health information to a third party.
  • The Secure Electronic Messaging objective is changed for 2015 (The capability for patients to send/receive secure electronic messages with the EP was fully enabled during the reporting period) and 2016 (A secure message is sent to at least 1 patient seen by the EP during the reporting period).

Read more:

Summary from

Details from the Mother Ship


Posted by Jim Sherrill | Topic: News  | Category: News

History Lesson

September 30th, 2015

It starts tomorrow, so you do not have time for this video now; but after the dust settles (does it?), you may enjoy learning where all these codes came from:

ICD-10 history - from

Of course, the United States using ICD codes for billing makes us uniquely late to ICD-10, but press on as we all decipher the new ways to work.


Posted by Jim Sherrill | Topic: News  | Category: News

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