The MIPS Process: What to Expect
A streamlined process created to help your practice thrive.
Step 1: Initial First Call
Determine your eligibility & make sure you qualify for our MIPS service. This initial call will take about 15 - 30 minutes.
If it is determined that your practice meets the right criteria, we will process the proper documentation and proceed to step 2.
Step 2: Onboarding
This is a technical call with your account manager. Here we will gain the proper access to your data so we can begin our data processing.
Access to your EMR system is ideal for a quick and seamless handoff.
Step 3: MIPS Data Reporting Process
Our team will begin the MIPS data processing. This can take between 2-4 weeks depending on size and scope of your practice.
Step 4: Review Prior to Submission
We will conduct a follow up call after the data has been processed. We will review our findings and discuss optimal plans moving forward.
Step 5: Submit MIPS Report
After submission, you should expect to get your results 4-6 weeks after the deadline of March 31st.
Frequently Asked Questions
Who can be eligible for MIPS?
MIPS eligibility is based on a clinician's National Provider Identifier (NPI) and the associated Taxpayer Identification Numbers (TINs), referred to as the TIN/NPI combination. You must be identified as a MIPS eligible clinician type on Medicare Part B claims, have enrolled as a Medicare provider before end of the previous year, and not be a Qualifying Alternative Payment Model Participant (QP).
Eligible Clinicians (but not limited to):
Physicians, Physician Assistants, Chiropractors, Clinical Nurse Specialists, Nurse Practitioners, Physical Therapists, Occupational Therapists, Clinical Psychologists, Certified Register Nurse Anesthetists, Qualified Speech-Language Pathologists, Qualified Audiologists, Registered dietitians or nutrition professionals, Qualified speed-language pathologists, Certified Nurse Midwives, Osteopathic Practitioners
What are the four performance categories for MIPS?
MIPS adjusts Medicare Part B payments based on performance in four performance categories:
Quality (30%)
Cost (30%)
Promoting interoperability (25%)
Improvement activities (15%)
What happens if you do not report MIPS?
Unless you qualify for an exemption from MIPS in a year, you will receive a -9% payment adjustment to your Medicare Part B fee-for-service (FFS) claims in the following year.
What is the cut off date for MIPS reporting?
You must report data collected during the calendar year by March 31 of the following calendar year.
Payment adjustments, based on the data you submit for services provided, are applied to Medicare Part B claims during January 1 to December 31 of the year following data submission.
