FAQ

Why is having an electronic health record (EHR) important?

There are many benefits of an EHR:

Efficiency: EHRs give providers the ability to share patient data with colleagues and patients; to retrieve old data effortlessly; to view test results prescribed by other doctors; and the ability to access patient records remotely to answer patient questions intelligently from outside the medical office.

For the patient volume calculation, can I include my managed care clients?

Any encounter an eligible professional (EP) has with a Medicaid client (whether it’s paid through a capitated arrangement with an HMO plan or fee-for-service claim to TMHP) can and should be included in the patient volume calculation.

What are the incentive payments and eligibility requirements for pediatricians?

There are special eligibility rules and payment amounts for pediatricians. Those with a Medicaid patient volume threshold between 20 percent and 30 percent will receive a maximum of $42,500; however, pediatricians with 30 percent or more Medicaid patient volume can still receive up to $63,750.

How do I get started in the Texas Medicaid EHR Incentive Program?

At the Centers for Medicare & Medicaid Services (CMS) Getting Started page https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Getting_Started.html there are links to eligibility and registration to begin the process.

I work in a group practice. Is each provider in the practice eligible for incentive payments or do payments apply to the practice as a whole?

The incentive program is based on the eligibility of individual practitioners, or eligible professionals (EPs), not the group practice. Each EP in your group will need to apply as an individual provider, although you may be able to attest to your Medicaid patient volume threshold as a group if you meet the criteria.

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