2018 Mid Year Update Webinar

June 6th, 2018

Live Question and Answer Session

Comments regarding the webinar: 

There was an error on the CMS website in the beginning of the webinar regarding where it states MIPS eligibility requires $90,000 AND 200 patients. It should be $90,000 OR 200 patients.

Regarding MIPS measures: You do not have to have hundreds of patients to meet the measures. You need at least 20, but you do need to report on at least 60 percent of your eligible patients. If you do not meet the minimum, Sammy will pick one of the other measures you performed well on to report. The whole idea of reporting these measures at the end of the year is to make you look good! We will show your best as the 6 measures and add any other measures you performed well on, especially if they are the podiatry measures.

Biomedix MIPS quality measures: Any questions regarding these measures, please contact Biomedix for additional information regarding how they work with the Biomedix device.

  1. Can you group report for this year?
    1. Yes.
  2. Can I stop having my staff do patient education, ports and emails tomorrow?
    1. Yes as long as the hardship exemption gets completed when it is due.
  3. Are the billing courses going to be online?
    1. Yes.
  4. Is the follow up collection service separate from the Sammy billing service?
    1. Yes, it is available as a standalone as well as included in the billing service offering.
  5. How come when I look our NPI on that website, it says enrolled in Medicare before Jan 1, 2018 it says "no"?
    1. You will need to check with CMS regarding this.
  6. I am on the long island railroad many hours per week. Will the app allow me to do notes as I commute?
    1. The next version of the app will allow this.
  7. So, no more asking about smoking? Flu shots? Please review what we can stop doing and please stop our printer!
    1. We will be providing an updated MIPS 2018 sheet within the next few weeks to all clients to address this question.
  8. The measures that ICS added for heel pain, etc. are still red. I thought I was doing them?
    1. There are a few reasons this may be happening. It requires at least 2 visits, the diagnosis to be in your note, and the pain scale must go down.
  9. If a practice is exempt from MIPS, is there any benefit to using the multitude of measures in Sammy and is there a benefit to reporting anyway?
    1. There is no benefit to reporting MIPS is you are exempt. However, there is a benefit to recording the data in Sammy that may be shared with the associations.
  10. For the minimum requirement of 200 patients for MIPS, is it all patients or just Medicare?
    1. CMS is looking to ensure you have more than 200 unique Medicare patients OR over $90,000 in Medicare approved charges to determine if you are eligible for MIPS.
  11. Sammy recommends to use a different jump drive for each day of the week. If a practice uses one external hard drive, the new copy overwrites the previous day. Can you have an option to keep multiple copies on one drive?
    1. Not without development. Please contact your IT to discuss. We do not recommend this option because that does not enable you to have a copy offsite.
  12. Big additional expense for the cloud?
    1. The price is based on the practice's data size and specific needs. Please contact us if you would like a quote. 
  13. Can we use our current hardware / software for the cloud?
    1. Your existing equipment SHOULD be ok because you will connect to the cloud via internet connection. We do a verification prior to upgrading you to ensure there will be no issues.
  14. Regarding practice improvement activities, does that include nursing home patients if seen after hours? (Regarding 24/7 access: IA_EPA_1)
    1. After hours is defined as hours of the day or night when your office is not open or when you are not usually working at that time.
  15. Will the billing and collection service be podiatry specific?
    1. There will be specific podiatry trained staff handling the podiatry billing and collections, and others will be available to handle general medical billing.
  16. Can we automate the chart reviews?
    1. We probably could, but I don't think you want us to because you want to see exactly what it is that you will be sending them. If we just went in and pulled it in some AI mechanism, you would still have to review them all before they would go out. If that's the idea of the question, that is something we could look into doing. I know these audits are not getting less and less; they are getting more and more.
  17. Does it only record MEX measures if you bill? Also if you create your own template, will it record?
    1. Yes to both.
  18. Does Sammy flag us if patients are due for 126 or 127 measures? Quarterly, annually, etc.?
    1. The red border around the exams will tell you that, and also the measure buttons will be red.
  19. What is the website you gave earlier in the webinar?
    1. https://qpp.cms.gov/participation-lookup
  20. I usually use the bunion as secondary diagnosis and usually no pain is associated with it...
    1. Any diagnosis if you don't do it will count against you. If the bunion diagnosis is in your note, then it will count against you if you do not associate the pain level for the bunion regardless if the bunion is the first or second diagnosis.
  21. Does Sammy eligibility do NJ medicaid patients?
    1. Yes.
  22. Is the MIPS reporting period for 90 days or 365 days?
    1. Quality reporting is 365 days in 2018.
  23. How do we test our backups?
    1. Feel free to send us a USB stick and we will check it out for you.
  24. For MIPS 2018, do the smoking status and falls need to be re-recorded?
    1. Smoking status needs to be updated every 2 years in the onescreen or social status. Falls must be re-recorded each year.
  25. In the appointment calendar, how do we see if patients for a previous date of service have notes and claims? So far we've only been able to view the current date of service.
    1. You can click on a previous day as long as the morning index has run and that button should be there.
  26. Will Sammy's billing service autopost the claims too?
    1. Yes.
  27. Do you have an interface to check Fidelis insurance eligibility?
    1. Yes. It is part of the eligibility subscription.
  28. My end of month report only shows one month at a time.  How did Ken get his report to show, for example, a comparison of how many new patients were seen side by side (on the same page) for 2016, 2017, 2018, etc?
    1. There is a checkbox on the bottom for recap. Check it off.
  29. When will communications to referring providers be available by internet fax?
    1. This is in beta testing and will be available shortly.
  30. How does Sammy record the outside hours if there is a separate template?
    1. There is no separate template. Simply add the words described in the webinar into your note. "I spoke to the patient outside hours, mention the date/time you had the conversation and / or saw the patient (put the time in your note). This may also be saved / tracked into the file cabinet in Sammy.
    2. Go to the file cabinet and create a drawer titled "Practice Improvement". In the letter generator, make a small form letter that has the information in  it. It does not have to be a chart note. A letter is sufficient. In the note for the same day, you can mention the rest of the information in the note.
  31. If a patient has heel pain and it is covered by insurance or not, everything regarding the measures applies. Any time there is a DX of heel pain or the others and/or in the claim, you should record the pain level.
  32. Billing service information
    1. When we researched the billing service opportunities here, and in listening to everyone in the last 6-9 months, we gathered lots of information from many sources in regards to billing services and how they work. We are putting together a team of resources and I'm not going to go too much more into it right now as to who they are and how it works, but they are going to be doing all of the work. The traditional billing service is just that; it will be a percentage based on the size of your practice and the billing service will do it all. It occurred to me that there are a lot of my clients who don't need the billing service to DO the claims. They just need someone to follow up on the claims. As a result, now you have different practices with different needs just on follow up on rejections, items that don't get paid. The insurance collection service will basically look over claims that did not get paid properly and simply follow up on those for a fee. We will provide you with more information shortly. We are committed to do this. 
  33. NY State Agreement
    1. If you are a New York state association member and don't have Sammy, there is a discount available for you. There is also a discount available for you if you want to use MX Connect. 
  34. Cloud
    1. For the last year or so, 99% of new Sammy clients have been put on the cloud. Our cloud is different than the traditional cloud. A traditional cloud is OK, but it's not as good as the private cloud (what we use now) which is more secure, data wise. However, due to technology and how quickly it is changing, we will be rewriting the program to work on the traditional cloud. Today, all of you who are not on the cloud, there is no rush to get on the cloud unless you are having problems with your older hardware or hardware that is not configured properly based on the latest Microsoft updates. It may make sense for you to upgrade now to save $ on hardware costs. As soon as we get the traditional cloud program done, we will move everyone over. That is a ways away; at least 9 months, probably more. We will be looking for beta testers on that as well. 
  35. The backup
    1. The middle backup button is ONLY for those who have a 3rd party backing you up. If you do not use a 3rd party backup or our OSB, make sure you put your flash drive into the computer and click 'Large backup'. Just doing the middle option just puts the database into your dataset so that when your 3rd party backs up, you get a complete backup. 
  36. We are a small office not using EHR. Do we still have to sign up for the registry? Are the MIPS boxes going to show up after every claim?
    1. If you are not on EHR (SammyUSA or SimpleSam), if you don't report either on claims or through a registry, you will get a MIPS penalty in 2020 for 2018 reporting. There is a minimum amount you can do to avoid the penalty. Depending upon what your amount of Medicare Part B is, you may not have to report. You may be exempt. https://qpp.cms.gov/participation-lookup
  37. How about a collection service for money owed from patients?
    1. The collection department will also follow up on patient payments as well as insurances.