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Quality Payment Program: A Path to Better Healthcare OutcomesXpertRCM provides Quality Payment Program services, helping medical practices meet quality care standards and succeed under CMS healthcare guidelines. Our tailored medical billing solution integrates seamlessly with these services, ensuring your practice not only complies with regulatory requirements but also optimizes its revenue cycle. By focusing on accuracy, efficiency, and adherence to healthcare standards, XpertRCM supports your journey toward achieving higher performance scores and financial success under the Quality Payment Program.
Healthcare providers want to ensure they are fairly reimbursed for their services while complying with the CMS Provider Government Funded Programs. At XpertRCM, we make it easier for practices to meet HEDIS quality measures. We offer data abstraction, care gap analysis, and population health management services, helping practices navigate the complexities of the CMS Quality Payment Program while also optimizing medical revenue services to enhance financial performance.
Our government-funded Programs healthcare suite helps medical providers with the Merit-based Incentive Payment System (MIPS). Our specialists assist medical practitioners in meeting the measures of the Provider Government Funded Programs. XpertRCM is the solution for maximizing incentive payments and minimizing penalties for healthcare providers. Our HCG experts ensure that providers receive the highest possible score on quality performance, leading to positive payment adjustments and preventing penalties. Our Medicate Billing Program supports seamless integration with government Funded Programs, enhancing billing accuracy and overall efficiency.
Transform your medical practice into a medical home with XpertRCM. We have the expertise to help you make this transition smoothly. We’ll provide the resources and support you need to offer coordinated, patient-centered care. Contact us today to learn more about how we can assist you.
We analyze various aspects such as practice size, care coordination, and patient-centered medical home (PCMH) model functionality. We work with you to develop a tailored approach for your PCMH certification and recognition needs. XpertRCM offers a variety of tools and resources to help providers comply with PCMH requirements, including training modules, process templates, and reporting tools. We also provide virtual front desk services to enhance patient engagement and streamline administrative workflows, ensuring a smooth implementation of the PCMH model in your practice.
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HEDIS and Care Gap requirements are always changing, making it hard for providers to keep up. Many providers lack the staff or resources to meet all the requirements, which can be time-consuming and burdensome. Not complying with HEDIS and Care Gap requirements can lead to financial penalties. We offer a comprehensive gap assessment to identify areas of noncompliance, customized remediation plans to close gaps in care, and ongoing quality improvement support to ensure continued compliance. We take the hassle out of compliance for healthcare providers and medical practices, allowing you to focus on providing quality patient care.
The MIPS program can be confusing and overwhelming, but it's crucial to participate to receive full payment for services. XpertRCM offers valuable MIPS services to help your medical practice succeed under CMS guidelines. We'll help you achieve a high MIPS score to avoid negative payment adjustments. Turn your medical practice into a medical home today!
Our team of experts will work with you to create a personalized care plan for each patient. Our software will help automate the process and track their progress. The care management team designs a comprehensive care plan for each patient, and you implement it. Our CCM services help providers meet the quality care measures required by CMS guidelines. We offer a range of services tailored to your organization's specific needs. We provide the tools and resources needed to succeed and offer ongoing support to ensure you continue to meet the required quality measures. XpertRCM offers valuable MIPS services to help your medical practice succeed under CMS guidelines. We'll help you achieve a high MIPS score to avoid negative payment adjustments. Turn your medical practice into a medical home today! XpertRCM offers valuable MIPS services to help your medical practice succeed under CMS guidelines. We'll help you achieve a high MIPS score to avoid negative payment adjustments. Transform your medical practice into a medical home today!
At XpertRCM, we are dedicated to helping healthcare providers succeed with the CMS Provider Government Funded Programs. We offer a suite of services to assist with HEDIS/care gaps, PCMH, MIPS, CCM, and RPM.
XpertRCM will offer suggestions for improvement after evaluating your practice. Our team will assist you in making these adjustments to meet PCMH standards and enhance the quality of care you offer to your patients.
We’ll give you continuous technical support as you work towards achieving PCMH recognition and certification. Our assistance will include troubleshooting any issues that arise from changes in standards or processes.
We’ll handle the submission of your application to NCQA on your behalf. XpertRCM has a team of experts knowledgeable about the standards and requirements of the National Committee for Quality Assurance (NCQA). We’ll collaborate with you to ensure that your application fulfills all the necessary criteria.
We’ll assist you in pinpointing care gaps, creating action plans to address them, and offering continuous support to ensure your patients receive the high-quality care they require and deserve. This approach will aid in enhancing your quality measures.
As part of our care gap services, we provide educational materials and workshops for your staff on quality improvement subjects like HEDIS, the Provider Government Funded Programs, and the PCMH. We collaborate with you to enhance your HEDIS scores.
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The QPP is a Medicare program aimed at shifting reimbursement from volume to value by promoting quality and value-based care. It incentivizes healthcare providers to participate in Advanced Alternative Payment Models (APMs) or the Merit-based Incentive Payment System (MIPS).
Eligible clinicians including physicians, physician assistants, nurse practitioners, clinical nurse specialists, and certified registered nurse anesthetists who meet certain billing thresholds are required to participate. Clinicians can check their eligibility status on the QPP website.
Reporting requirements vary depending on whether clinicians participate in MIPS or Advanced APMs. MIPS participants report data in categories such as Quality, Promoting Interoperability, Improvement Activities, and Cost. Advanced APM participants report on their participation in an eligible APM and may be exempt from MIPS reporting requirements.
Clinicians participating in MIPS may receive positive payment adjustments based on their performance scores, while low performers may face negative payment adjustments. Advanced APM participants may qualify for a 5% bonus payment and are exempt from MIPS reporting requirements. However, participants in both tracks should be aware of potential changes in program rules and benchmarks that could impact their payments.
TESTIMONIALSWe're really happy with the service we get from XpertRCM. Lucas is amazing and always there when we need him, and the whole team knows their stuff and is super polite. I'd definitely recommend this company to others! Thank you very much team XpertRCM!
I'm thankful for working with XpertRCM. They made it easy for me to switch from my old biller. I have no regrets so far. Lucas and Alex have been very helpful, happy to bring my other company as well. Thank you XpertRCM and Lucas , Alex, and Abul
I've been using XpertRCM since I started my practice in 2018, and I'm really happy with their service. They're a great team—friendly, helpful, and always there when I need them. I've even recommended them to some friends. Shoutout to Danny, Lucas, and William for being especially awesome
For the past five years, I've worked closely with various members of the XpertRCM team across different medical practices where I provide diagnostic services. I've been really impressed by their professionalism, dedication, communication skills, and how efficiently they work.
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