Representing a departure from the volume based, fee-for-service model, MACRA replaces the SGR (sustainable growth rate) formula to control Medicare costs. Linking Medicare reimbursements to quality metrics with providers being rewarded for quality and value based care; MACRA repeals the set payment rates based on economic growth, which was the hallmark of SGR.
After ICD-10 went live on October 1, 2015; CMS (Centers for Medicare and Medicaid Services) allowed a one year grace period for ICD-10 flexibility, to overcome the strong opposition from the AMA (American Medical Association) to ICD-10 implementation. For the one year period, even though a more specific code existed, CMS allowed healthcare providers to submit claims with a valid code from the ICD-10 three character category,
In order to keep your practice afloat, it is imperative that your services receive full and timely reimbursements. Getting your cash flow moving smoothly depends on accurate coding along with timely submission of your bills to the relevant insurance carriers. Incorrect coding can lead to your reimbursements being delayed, denied or rejected. If you have a small or specialty practice,