This topic contains a solution. Click here to go to the answer

Author Question: What is a physician quality reporting system (PQRS), and who created ... (Read 51 times)

misspop

  • Hero Member
  • *****
  • Posts: 540
What is a physician quality reporting system (PQRS), and who created it?

Question 2

Distinguish between the two basic approaches to utilization management: prospective review/precertification and retrospective review.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

nixon_s

  • Sr. Member
  • ****
  • Posts: 359
Answer to Question 1

The physician quality reporting system is a reporting program that uses a combination of incentive payments and payment adjustments to promote reporting of quality information by eligible providers. The PQRS was established by the Centers for Medicare and Medicaid Services.

Answer to Question 2

In prospective review/precertification the service is examined before it is provided. Data are collected from the patient and the physician to compare the data to appropriate criteria. If the standards are met, the service can be provided. If the standards are not met, a physician advisor may be asked to review the case and make a determination. In retrospective review, care is looked at after it is given. Data are collected from a sample of medical records, and the information from the record is compared to the appropriate standards. Feedback then is given to the caregiver regarding inappropriate care provided.




misspop

  • Member
  • Posts: 540
Reply 2 on: Jul 12, 2018
YES! Correct, THANKS for helping me on my review


Liamb2179

  • Member
  • Posts: 365
Reply 3 on: Yesterday
:D TYSM

 

Did you know?

There are major differences in the metabolism of morphine and the illegal drug heroin. Morphine mostly produces its CNS effects through m-receptors, and at k- and d-receptors. Heroin has a slight affinity for opiate receptors. Most of its actions are due to metabolism to active metabolites (6-acetylmorphine, morphine, and morphine-6-glucuronide).

Did you know?

There are 60,000 miles of blood vessels in every adult human.

Did you know?

All adverse reactions are commonly charted in red ink in the patient's record and usually are noted on the front of the chart. Failure to follow correct documentation procedures may result in malpractice lawsuits.

Did you know?

Normal urine is sterile. It contains fluids, salts, and waste products. It is free of bacteria, viruses, and fungi.

Did you know?

As many as 20% of Americans have been infected by the fungus known as Histoplasmosis. While most people are asymptomatic or only have slight symptoms, infection can progress to a rapid and potentially fatal superinfection.

For a complete list of videos, visit our video library