More CMS Guidance on EHR Incentive Program Issues

FAQ for EHR Incentive Program Questions

If you have a question about the EHR Incentive Program that isn’t answered or obvious in the pages and fact sheets from CMS then try their FAQ option. You can find answers and guidance on just what is not so obvious. Here are some recent issues and additions to their database.

In the Medicaid Program EPs are eligible by being a certain kind of provider and meeting a Medicaid patient volume. In some States, billing for a patient can include multiple visits in a bundle or global rates. You might find this in an obstetrician’s billing. So how do you determine the Medicaid volume in these instances?

Of course if it is a Medicaid question you must always refer to the individual State plans for additional information, instructions, or requirements. In this instance CMS leaves it up to the states how to operationalize the patient volume considerations of global payments with the following guidance:

  • The numerator and denominator must be incorporated consistently.
  • The total encounters can be kept global, or broken down into individual visits.
  • If a global payment is broken down into separate visits in the numerator, then for purposes of the denominator, the state must break down any other global payments received from other payers.

While this might appear to be a bookkeeping nightmare, CMS actually recognizes the “administratively challenging” process. They say they are open to reviewing strategies that might involve sampling. CMS also states that “if the state’s approach to global payments excludes providers from the Medicaid EHR Incentive Program who would otherwise be eligible, the state must create a mechanism to re-review their eligibility.” Read the CMS question and answer here.

Are you a Medicare Eligible Professional and looking for your incentive payment? Look for your money around four to six weeks after you have successfully attested to meaningful use. But remember if you have not reached the maximum billable dollar amount of $24,000, CMS will hold your payment until you do or the deadline for claim submission on February 29th. For more detail on this check out this FAQ.

And finally, we have reported on the upgrades to the CMS EHR Information Center’s Interactive Voice Response System (IVR). CMS is now reporting more services beginning February 16th to the Center and IVR system through the “Self-Service Tool”. The option contains privacy measures and requires an NPI, the last 5 digits of your TIN, and your EHR registration ID. The new options will allow you to obtain registration status, acquire attestation status, review payment information, and check progress of meeting the $24K billing threshold. To access the IVR call 888-734-6433, the self-service tools are option number 3.