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PQRS is a way for Medicare to track medical conditions monitored by Doctors. A doctor who submits CPTII codes and G Codes with his/her billing to Medicare for predetermined "measures" has the possibility of receiving a 1% bonus pay of the approved Medicare Payments for all of that doctor's Medicare. Manually determining which codes to submit can be labor intensive. MEDENT has programmed all this into the MEDENT EHR/EMR. It is a highly automated feature in the system and seeing a demonstration is very exciting. This feature also complements the Disease Management area of the system described below. Disease Management Formulas (DM/HM) are used to provide a summary of needed preventative health care for the Patient base, as well as to provide exception and performance reports. DM/HM are scripts that contain filters which sift through applicable measures and analyze medical data facts in a Patient's chart to determine if that Patient should be selected for medical action by the Doctor. These measures may look at how long it has been since the Patient has been in for a visit, consider diagnoses, vital sign levels, lab test results, age range and sex, etc.. The formulas run when the DM/HM button is clicked from within the chart, during the scheduling process, or from progress notes. The Disease Management formulas can also be set to automatically run when entering the patient's chart. The displayed result organizes preventative health measures into areas color coded for timeliness. Health measures that are due are in red, those coming due are in pink, and those that have been performed and are not yet due again are in white. In the Chart Disease Management (DM/HM) screen, the formulas may be overridden or customized for the patient. They can also be run against the complete Patient base, or part of it based on a wide selection criteria (DM/HM), or the schedule for a specified period of time. These formulas are also used for incentive programs such as "Patient Centered Medical Home" and "Meaningful Use".
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