Reconcile your EC listings with CMS PECOS and QPP

How to square up with cms


Your EHR is the start - but not the finish

All reportable metrics come from EHR technology, for providers not part of ACOs.  Even within ACO, PI scores are EHR driven, and some CQM is EHR driven as well.  EHR needs to define your relationship between EC and TIN.  But if your EHR does not match  CMS systems, you stand to lose reimbursement. 

Matching is even more critical for an Advanced APM.  

PECOS drives activity

PECOS is where providers re-assign their billing rights to TINs, and is what determines how data appears in the QPP lookup site.  PECOS mismatches need to be cleared up early in the year, at least a couple months before the August 31 QPP claims snapshot.   

QPP drives reimbursement

QPP is where you verify detail MACRA eligibility for:

  1. Medicare volume, both as group and individual;
  2. Sufficient history with Medicare;
  3. Appropriate provider type;
  4. Group affiliation;
  5. Volume of at-risk patient encounters (for Advanced APM);
  6. ACO affiliation.

Smart provider groups check QPP early in the year (second calendar quarter) and after the August 31 data snapshot. 

Our systems, and our Monthly Concierge team handles these time-consuming chores on your behalf.  

Give us a call about having our team perform a quick reconciliation for you!