PQRS: The Case for Registry over Claims Based Reporting

Here at WebPT HQ, we are gearing up for PQRS 2012. One of the pieces of PQRS that is most commonly misunderstood is the difference between claims and registry based services. Let's take a minute and clear this up.

Claims and registry-based reporting both result in the same outcome for your clinic-- successful participation in PQRS. WebPT offers both options with claims-based being priced $99 per calendar year and registry-based at $299 for the calendar year. Many people look at the price and automatically assume claims is the way to go. Not so fast. There are some major cost and workflow considerations when taking on the claims-based beast.

A PQRS claims form has to be filled out in accordance with each note completed. These forms are usually at least a page long and have to be managed and periodically submitted over the course of the year according to dates specified by CMS. In our experience, clinics need to have a dedicated staff member to manage the process or they need to pay a billing service provider to manage the process for them. Both of those options cost significantly more money than the attractive $99 fee for claims. All of the sudden, your clinic has spent a lot more time and money on PQRS than you previously anticipated.

Another issue with claims-based reporting is that it’s a manual process. We know that nobody loves PQRS. It adds work for therapists and staff. If you participate in claims-based reporting you have to report on at least 50% of patients to be considered successful. If you missed this mark due to human error, you are simply out of luck. In 2013, if you miss your 50% reporting, you will actually lose 1.5% of your eligible fee schedule payments in 2015.

With the WebPT registry-based option, most of these considerations are managed for you. Because we merge PQRS and standard documentation, the workflow issues for therapists are drastically cut down. Therapists can document their PQRS measures directly into their document. We aggregate that data for the digital forms and submit them to CMS. After setting up PQRS for your clinic, registry-based reporting will allow you to leave it up to us after the point of documentation.

With a registry-based option you are required to report on 80% of eligible patients. While this is more than claims, it becomes somewhat misleading. Because the registry-based option is integrated with WebPT, we can utilize our checks and balances system to ensure compliance. Therapists will be alerted throughout their note and will only be able to finalize after reviewing the PQRS data for their patients. Most of our registry-based clinics actually end up achieving a 100% participation rate with our registry.

WebPT had to go through a rigorous process with CMS to become a certified registry. We did the work for you to make PQRS easier for physical therapy clinics everywhere. At $299 for the entire year, the benefits involved with simplifying PQRS are great.

If you have a billing company or a full time staff member who has the time and experience to devote to PQRS, then claims-based may be for you.

Otherwise, the WebPT Certified Registry is the easiest and safest way to ensure successful participation in PQRS.

If you would like to learn more about PQRS you can view our recorded webinar or contact the WebPT Success Team at success@webpt.com.