Approved preventive health services with co insurance and Deductible waived.
What is MACRA ?
MACRA stands for Medicare Access & CHIP Reauthorization Act 2015 :
Three major steps :
1) Ending sustainable growth rate for determining Medicare payment for health care provider service
2) Making new framework for rewarding health care provider for giving better care not just more care
3) Combining our existing quality reporting program's in to one new system
These proposed changes replace a patchwork system of Medicare reporting program's with a flexible system that allows you to choose two path of links quality of payments .
MIPS - Merit based Incentive Payment System.
It's a combination of PQRS, Value based payment modifier and EHR.
APM - Alternative Payment Model
2019 - 2024 Lump sum incentive amount, increased transparency of physician focused payment model.
Starting 2026, offers some participating health care provider higher annual payment.
SOCIAL SECURITY NUMBER REMOVAL INITIATIVE
MACRA Requires us to remove SSN from all Medicare cards, when replace SSN on all Medicare cards we can better protect.
Private health care and financial information.
Federal health care benefit and services payment.
Effective with services rendered October 1, 2015 and later, ALL ambulance transports require dual diagnoses. Providers should report the primary diagnosis as the most appropriate ICD-10 code that adequately describes the patient’s medical condition at the time of transport. In addition, a secondary diagnosis must be reported which reflects the patient’s need for the ambulance service and ambulance personnel at the time of transport. In order for claims to be processed and paid in a timely manner it is important that claims submitted for ambulance services contain both the primary and secondary diagnosis.
Please refer to the Ambulance Local Coverage Article A54574 for a list of “suggested” ICD-10 codes that may be reported as a primary diagnosis. Please note that the list of diagnosis codes provided in A54574 is not an all-inclusive list. Other valid ICD-10 diagnoses codes that accurately describe the patient’s condition at the time of transport may be reported as a primary diagnosis. Please refer to the Ambulance Local Coverage Determination (LCD) Policy for a list of four covered secondary diagnosis codes (Z codes). The secondary diagnosis code should reflect why the transport is reasonable and necessary. If the transport is not reasonable and necessary the LCD provides a non-covered Z code.