What is HEDIS? The Basics, Objectives and Significance
One of the most important tools utilized by payers across the country is the Health Effectiveness Data and Information Set (HEDIS), which is maintained by the National Committee for Quality Assurance (NCQA). HEDIS is a measurement set used to determine the efficacy of...
Why Your Final MIPS Score Might Be Different from What You Expected – and What You Can Do About It
If you’re participating in the Merit-based Incentive Payment System (MIPS) or MIPS Value Pathways (MVPs), you’ve likely encountered a familiar scenario: you review your estimated MIPS score in your dashboard, only to find that months later, when CMS releases the final...
Modern Efficiencies for a Modern Audit Team: MRO Experts Share How to Reduce Risk
Internal audits and monitoring are essential practices to ensure coding and billing compliance, protect revenue, and defend against payer audits and clinical denials. However, with limited time and resources, it becomes impossible to internally review every physician,...
Exploring the Future of Payer-Provider Data Exchange: Insights from MRO and CHIME’s Recent Research Report
As healthcare moves deeper into the digital age, the seamless exchange of clinical data between health systems and payers has become increasingly critical. Earlier this year, MRO in collaboration with the College of Healthcare Information Management Executives...