Prescribe Electronically Via a Qualified E-Prescribing
(eRx) System

HealthFusion's® e-prescribing (eRx) system 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.

Frequently Asked Questions about the Medicare E-Prescribing
Incentive Program

Is HealthFusion's® e-prescribing 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 2011, e-prescribing incentive amounts will be only 1% 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 the E-Prescribing Program.

With growing fears of e-prescribing penalties, the federal government offered a "work around". EHR users simply had to remember to include special G-codes on at least 10 claims to avoid the 2012 e-prescribing penalty. As usual, MediTouch® responded quickly and installed a tool that, with a single click per encounter, assisted providers in passing the proper G-code to Medicare, so they could avoid the 2012 e-prescribing penalty. With so many issues with the e-prescribing program, the government has proposed a new rule, which offers certain “waivers” to the current e-prescribing bill. With the new e-prescribing rule, G-code or no G-code, meaningful users of EHR technology will not be penalized by the e-prescribing incentive program in 2012.

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.

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%.

Can I use the HealthFusion® e-prescribing 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.

Surescripts® Certified

As a Surescripts® Certified Solution Provider, MediTouch® is recognized as advancing electronic prescribing and healthcare interoperability with customers in the United States. As a Surescripts® Solution Provider, MediTouch® clients and their patients are ensured a safe, efficient, and quality prescribing process. Surescripts® has already guaranteed readiness once e-prescribing of controlled substances becomes available, so you can be sure MediTouch® will be ready as well.

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-prescribing 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-Prescribing:

1. Contact your HealthFusion® sales representative to sign up for HealthFusion’s® eRx solution.
2. Add the G-Codes to your superbill.
3. Use the appropriate G-Code for each eligible visit.