e-Prescribing
e-Prescribe
Beginning in 2009, Medicare will pay bonus incentives to practices that prescribe electronically via a qualified e-prescribing (eRx) system.
In the next couple of years, this Medicare incentive plan can generate thousands of dollars in new revenue for your practice.
HealthFusion's e-Prescribe works seamlessly with the HealthFusion Practice Management System and Clearinghouse – and is compliant with the Medicare e-Prescribing directive. If your patients and providers are already entered in the HealthFusion® system, you can begin to prescribe with just a couple of clicks and keystrokes. If your patients and providers are not already in the system, we can assist you in loading your data very quickly.
Key Benefits:
- Prescribe directly from patient chart
- Drug-to-Drug Interaction warnings
- Drug Allergy warnings
- "E-Z" refill processes (reduce time-consuming refill phone calls)
- Pharmaceutical cost comparison capabilities (formulary)
- Pharmacy (local drug store) search with save favorites and default patient pharmacy options
- Pharmacy Benefit Plan search with save as default plan for patient option
- Generate patient specific medication lists and view on patient chart.
Frequently Asked Questions about the Medicare e-Prescribing Incentive Program
Is HealthFusion's e-Prescribe system compliant with the Medicare directive?
Yes, it meets all of the requirements outlined by the Centers for Medicare and Medicaid Services (CMS). You can learn more at the Medicare site.
What is the average projected incentive amount per doctor?
It depends on the amount of revenue your practice collects from Medicare. Many experts project approximately $1,500 - $3,400 in Medicare e-Prescribing incentives per provider in 2009 alone.
How did these e-prescribing incentives become law?
In July 2008, the Medicare Improvements for Patients and Providers Act (MIPPA) was passed. MIPPA is a step approach to mandating e-prescribing technology, and the act uses a "carrot and stick" approach. Early adopters are eligible for incentive payments, and providers who delay implementation of e-prescribing systems will be penalized for non-compliance.
How does Medicare calculate my incentive payment?
For 2009, e-prescribing incentive amounts will be 2% of the total estimated allowed charges for professional services covered by Medicare Part B and furnished by an eligible professional during the reporting period (one calendar year). For subsequent years, the tables below outline Medicare’s "carrot and stick" approach to e-prescribing.
How can I be sure that I am eligible for the Medicare incentive program?
You must be a professional whose estimated allowed Medicare Part B charges for the e-prescribing measure (evaluation and management) codes are at least 10% of their total Medicare Part B allowed charges.
What specific codes are eligible visit codes for the Medicare incentive program?
The codes in the table below are in the denominator of the e-prescribing incentive program measure during the reporting period. These are the codes for the encounters that will are eligible for measurement by the incentive program.
|
90801 |
90808 |
96150 |
99204 |
99215 |
G0101 |
| 90802 | 90809 | 96151 | 99205 | 99241 | G0108 |
| 90804 | 92002 | 96152 | 99211 | 99242 | G0109 |
| 90805 | 92004 | 99201 | 99212 | 99243 | |
| 90806 | 92012 | 99202 | 99213 | 99244 | |
| 90807 | 92014 | 99203 | 99214 | 99245 |
How does Medicare measure my performance?
- Step One – Eligible Visits
Submit claims as your practice normally would for the codes listed in the table above. These are the eligible visits (denominator). Remember, eligible visits must comprise at least 10% of your practice. - Step Two – G Codes
Add just one of the three “G Codes” listed in the table below to your claim when submitting claims for the eligible visits (numerator). We suggest you add these codes to your superbill. - Step Three – The e-Prescribing Formula
The formula is: e-Prescribing G - Code Usage / Eligible Visits must be greater than 50%.
| Code | Description |
| G8443 | All prescriptions created during the encounter were generated using a qualified e-prescribing system. |
| G8445 | No prescriptions were generated during the encounter, but the provider does have access to a qualified e-prescribing system. |
| G8446 | The provider does have access to a qualified e-prescribing system, but:
|
Can I use the HealthFusion e-Prescribe system to prescribe controlled substances?
Currently, the Drug Enforcement Agency (DEA) prohibits e-prescribing for controlled substances. The DEA has issued a proposed rule to allow e-prescribing for controlled substances under certain conditions. Even if the DEA allows e-prescribing for controlled substances, G-code G8446 allows you to report on the e-prescribing measure for controlled substances without using an e-prescribing system to do so.
The e-Prescribing Opportunity
January 1, 2009, CMS will provide an incentive to qualifying professionals that meet the e-prescribing formula (a successful e-prescriber). The sooner you participate in the program, the greater your chance of maximizing your incentive payment ("carrot"). Beginning in 2012, if you’re not a "successful e-prescriber," you will be subject to a penalty ("stick"). HealthFusion’s e-Prescribe solution is a qualified system that is also fully integrated with our Practice Management System and Clearinghouse solutions.
If you are a qualifying provider, making more money with Medicare is as easy as 1-2-3 with HealthFusion’s e-Prescribe:
- Contact your HealthFusion sales representative to sign up for HealthFusion’s e-Prescribe solution.
- Add the G-Codes to your superbill.
- Use the appropriate G-Code for each eligible visit.
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