Okay, so the title of this article might be a little misleading; the final rule isn’t health care’s just desserts. It’s actually really great that CMS is always trying to improve one of our country’s most important safety nets—even though its methods of doing so are divisive, to say the least.
I’ve spent an enormous amount of time researching MIPS—from digging through the 2,000-odd pages of the final rule and decoding line upon line of legalese, to participating in hour-long discussions (and dozens of email chains) with WebPT’s compliance experts. After all that researching, I feel pretty comfortable with the ins and outs of the program—as well as its benefits and drawbacks. So, let’s talk shop. Here are the pros and cons of MIPS participation:
If you’ve been in the rehab therapy game long enough, chances are, you’ve heard a thing or two about balance billing. But, if you’re out of the loop—or if you’re wondering what balance billing is, anyway—here’s the gist, according to this article from Becker’s Hospital Review: “The practice of balance billing refers to a physician’s ability to bill the patient for an outstanding balance after the insurance company submits its portion of the bill. Out-of-network physicians, not bound by contractual, in-network rate agreements, have the ability to bill patients for the entire remaining balance.”