Author: Rick Gawenda


  1. What is the accurate way to document MIPS so that I can get payment for doing so? Is the correct way to just follow the template for MIPS and fill in the bubbles ? Or is there a right/wrong way?
    I know on PQRS several years ago I did what I thought were correct steps but somehow didn’t meet the requirements and ended up getting less payment
    I would like to know the right way to do it so I am rewarded


  2. “The simplest way to know if you are a private practice under the Medicare program is that you submit claims to your Medicare Administrative Contractor on a 1500-claim form”
    We are a Part B provider and file on a UB04 form, will this still include us?

  3. Hi Rick…thanks for the article…what about the scenario if you don’t meet the 3 criteria in the first period…stay in the same practice…and then meet all three in the second period…do you have to report MIPS?

  4. Based on the 2018 MIPS numbers, none of our providers exceed all three low-volume thresholds. They exceed 2 of the 3. For this reason, we were planning on gathering more information before we decide to opt-in. However, when will we officially get the list for providers required in 2019? I’ve been told that Medicare isn’t going to release the list until March for the first determination period. Is this correct? What happens if you chosen not to opt in based on info you have, and then the list comes out and you were actually above all three low-volume thresholds?
    We are currently signed up for the Dec 18 webinar, but I’m being proactive.

    • CMS will not release the first determination period data until the first quarter of 2019. This may be one reason to report via registry and I will discuss this on December 18th during the webinar.

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