Products and Services

SureScripts® Certified Electronic Prescription Software

MTBC is a SureScripts White Coat of Quality Recipient for 2012. Our Surescripts® certified e-prescribing solution is integral to improving not only the efficiency of your practice, but also the quality of care that you provide to your patients. Plus, it’s included completely free of charge for our 5% billing clients!

E-Prescription

Why E-Prescribe?

  • Eliminate the time, paper and other costs associated with writing paper prescriptions.
  • Do away with inane, redundant phone calls and faxes to pharmacies.
  • Submit error-free prescriptions to virtually any pharmacy in the U.S. directly at the point of care.
  • Streamline refill requests and authorization processes.
  • Prescribe anywhere, anytime with MTBC iRx, our e-prescribing app for the iPhone™, iPad™ and Android based smart devices.
  • Automatically synchronize and update your EHR and patient database every time you submit a prescription, regardless of the point of access (web, EHR, MTBC iRx).

Most importantly, improve the overall quality
of care for your patients.

  • Avoid the risk of error due to illegible handwritten prescriptions.
  • Provide instant, accurate information about formulary-based drug coverage, formulary alternatives, drug information, complete medical history and even co-pay information.
  • Benefit from warning and alert systems that notify you of any adverse reactions or interactions with the patient’s other medication, allergies or illnesses.
  • Automatically assign dosage based on the patient’s demographic information.
  • Adhere to nationwide industry standard nomenclature so patients can refill their prescriptions no matter where they are.

You could be penalized for not e-prescribing!

Eligible providers who fail to e-prescribe and report G-code G8553 to Medicare at least 10 times before June 30, 2011 will be penalized in 2012. Those eligible providers will receive a payment adjustment of 1% of their Medicare allowed charges. You can avoid those charges by using our e-prescribing solution, which comes free with MTBC PracticePro and MTBC ChartsPro. Please click the links below for more information.

Frequently Asked Questions:

What is the eRx Incentive Program?

The Electronic Prescribing (eRx) Incentive Program is a reporting program that uses a combination of incentive payments and payment adjustments to encourage electronic prescribing by eligible professionals. The program provides an incentive payment to practices with eligible professionals (identified on claims by their individual National Provider Identifier [NPI] and Tax Identification Number [TIN]) who successfully e-prescribe for covered Physician Fee Schedule (PFS) services furnished to Medicare Part B Fee-for-Service (FFS) beneficiaries (including Railroad Retirement Board and Medicare Secondary Payer). Beginning in 2012, the program also applies a payment adjustment to those eligible professionals who are not successful electronic prescribers on their Medicare Part B services. The eRx Incentive Program is mandated by federal legislation.

Is there any sign up or pre-registration?

There is no sign-up or pre-registration for individual eligible professionals to participate in the eRx Incentive Program. However, there are certain limitations on who can qualify for an eRx incentive payment. First, an eligible professional must have and use a qualified eRx system and report on his or her adoption and use of the eRx system. Second, the eligible professional must meet the criteria for a successful electronic prescriber specified by CMS for a particular reporting period. Finally, at least 10% of a successful electronic prescriber's Medicare Part B covered services must be made up of codes that appear in the denominator of the eRx measure.

Who are eligible professionals to participate in the eRx incentive program?

Below is a list of 20 professionals who are eligible to participate in the eRx Incentive Program for the incentive payment. Eligible professionals must have prescribing authority in order to participate in this incentive program. Not all providers who are eligible to participate in the eRx Incentive Program for the incentive payment are eligible for future eRx payment adjustments. The following professionals (in normal text) are eligible to participate in the eRx Incentive Program for the incentive payment and are eligible for the 2012 payment adjustment (in bold text) if not successful at reporting the eRx Incentive Program measure:

Medicare physicians
  • Doctor of Medicine (MD) – subject to payment adjustment
  • Doctor of Osteopathy (DO) – subject to payment adjustment
  • Doctor of Podiatric Medicine (DPM) – subject to payment adjustment
  • Doctor of Optometry
  • Doctor of Oral Surgery
  • Doctor of Dental Medicine
  • Doctor of Chiropractic
Practitioner
  • Physician Assistant (PA) – subject to payment adjustment
  • Nurse Practitioner* (NP) – subject to payment adjustment
  • Clinical Nurse Specialist*
  • Certified Registered Nurse Anesthetist* (and Anesthesiologist Assistant)
  • Certified Nurse Midwife*
  • Clinical Social Worker
  • Clinical Psychologist
  • Registered Dietician
  • Nutrition Professional
  • Audiologists
Therapists
  • Physical Therapist
  • Occupational Therapist
  • Qualified Speech-Language Therapist
Is there any eligible professional who is not able to participate in the eRx incentive program?

The following professionals are eligible but are not able to participate for one or more reasons:

1. Professionals paid under or based upon the PFS billing Medicare Carriers/Medicare Administrative Contractors (MACs) who do not bill directly.

2. Professionals paid under the PFS billing Medicare fiscal intermediaries (FIs) or MACs. The FI/MAC claims processing systems currently cannot accommodate billing at the individual physician or practitioner level:

  • Critical access hospital (CAH), method II payment, where the physician or practitioner has reassigned his or her benefits to the CAH. In this situation, the CAH bills the regular FI for the professional services provided by the physician or practitioner.
  • All institutional providers that bill for outpatient therapy provided by physical and occupational therapists and speech language pathologists (for example, hospital, skilled nursing facility Part B, home health agency, comprehensive outpatient rehabilitation facility, or outpatient rehabilitation facility). This does not apply to skilled nursing facilities under Part A.

Eligible professionals participating in the eRx Incentive Program and their office staff should familiarize themselves with the eRx Incentive Program requirements for the relevant program year.

What is G8553 code?

G8553 indicates that at least one prescription created during the encounter was generated and transmitted electronically using a qualified eRx system.

What are the denominator codes?
  • Psychiatry - 90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862
  • Ophthalmology - 92002, 92004, 92012, 92014
  • Behavioral Health - 96150, 96151, 96152
  • Office visits - 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215 Nursing facility care - 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, Assisted Living/Domiciliary - 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337
  • Home visits - 99341, 99342, 99343, 99345, 99347, 99348, 99349, 99350
  • Pelvic/clinical breast exam - G0101
  • Diabetes Self-management training - G0108, G0109
How to avoid the -1.5% payment reduction in 2013?

Individual eligible professionals who are not successful electronic prescribers will be subject to a 1.5% payment adjustment on their Medicare Part B services provided January 1, 2013 through December 31, 2013. To avoid the 2013 eRx payment adjustment, individual eligible professionals would have had to have been a successful electronic prescriber in 2011 or will need to report the G8553 code via claims for at least 10 billable Medicare Part B PFS services provided January 1, 2012 through June 30, 2012

  • The incentive reduction is -1.5% of the eligible professionals total estimated Medicare Part B allowed charges.
  • The reporting period for the 2013 payment reduction is 6 months, January 1, 2012 through June 30, 2012.
  • The G8553 should only be reported via claim which is the only reporting mechanism to avoid the penalty.
How to get an eRx Incentive payment in 2013?

To receive an incentive payment in 2013, an eligible professional must report the electronic prescribing measure’s numerator code at least 25 times for encounters associated with at least 1 of the denominator codes using a qualified electronic prescribing system.

  • The incentive payment is 0.5% of the eligible professionals total estimated Medicare Part B allowed charges.
  • The reporting period for the 2013 payment incentive is January 1, 2012 through December 31, 2012.
  • There are three reporting mechanisms: claims, registries, or EHRs.
How do I know that G-Codes are being submitted?

eRx line items will be denied for payment, but are passed through the claims processing system to the National Claims History database (NCH), used for eRx claims analysis. Eligible professionals will receive a Remittance Advice (RA) which includes a standard remark code (N365). N365 reads: “This procedure code is not payable. It is for reporting/information purposes only.” The N365 remark code does NOT indicate whether the eRx G-code is accurate for that claim or for the measure the eligible professional is attempting to report. N365 only indicates that the eRx G-code passed into NCH.

Are there any exemptions?

The following hardship exemptions have been finalized for the application of calendar year 2013 penalty and must be applied online on the CMS Communication Support Page Website.

  • The practice is located in a rural area without high speed internet access (Previously reported with a G-Code)
  • The practice is located in an area without sufficient available pharmacies for electronic prescribing (Previously reported with a G-Code)
  • Inability to electronically prescribe due to Local, State, Federal law or Regulation
  • Prescribing or expecting to prescribe fewer than 100 prescriptions in the Jan 01 2012 to June 30, 2012 reporting period

To avoid the Medicare penalty, you must begin using E-prescribing now or apply for an exemption if applicable before June 30, 2012. Select the best suitable exemption for your practice by following the link below:

CMS will review your exemption and make the final decision on approval or denial. MTBC cannot guarantee if your exemption will be approved

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