The underlying foundation of Value-Based Care (VBC) is not based on limiting care or quality. It’s about aligning optimal patient care with financial benefit – for the patient, for the doctor, and for the unsustainable cost of healthcare to our overall economy.

The Provider Tune Up Platform is a vital and proactive solution for all MIPS eligible and exempt TINs, physicians, clinicians, ACO and Advanced APM members, and all payor classes (Medicare, Medicare Advantage, Medicare Shared Savings Plans (MSSP), Medicaid, Commercial – Insured and Employer Self-Funded Plans, and other Risk Based Reimbursement Plans).

CMS's Risk Adjustment Data Validation (RADV), Transaction Coding of Diagnoses Final Rules, the National Quality Strategy (NQS) requirements, and payment adjustments under the QPP & MACRA have begun. These have and will continue to create a significantly higher risk of an audit and could have a serious impact on your reimbursement.

We help you properly address your RAF Compliance, Patient Outreach, Health Information Exchange, and (if your are MIPS eligible) MACRA Optimization issues  (see our webpages and flyers for important details on each category).

Compliance is Now Incentivized

Though most TINs did a good job meeting compliance in the past, due to complexity and the failure of vendors and health plans to provide TINs and their providers with the proper expertise, tools, and/or training, 98% are NOT meeting requirement benchmarks and targets on at least one, but for some, all four categories.

Administrators even boast about their Quality scores, robust risk adjustment, abstract coding teams, QA audit teams, and provider education. Unfortunately, they are still apathetic about verification and action needed because up until now, fully meeting requirements has not amounted to any significant increase in revenue. This has now changed.

So, now when ownership, boards, and/or stakeholders ask why your TIN’s reimbursement has been reduced or why you failed to maximize reimbursement and/or the payment adjustment under the QPP & MACRA, and no one can explain why or do anything about it, ignorance or apathy will not be an accepted excuse. Don’t let this to happen to you!

All our category services are offered on a Clinic-by-Clinic basis and tailored to each clinic's specific needs, which can change from one year to the next. They require very little workload and no additional staffing requirements on your part, and for less than the cost of a single new hire.

We deliver Maximum Value and make the decision on whether to invest in optimization or stay the course with your ACO, vendor(s), or your own efforts, very easy.

The Provider Tune Up Platform is the empowering solution that will ensure you meet all category requirements and maximize reimbursement.

Unlocking Financial Rewards starts with a RAF Verification Analysis, and maximizing your payment adjustment begins with the MIPS Category Weights Data Analysis.

To determine the best course of action, we must first find out exactly where you are hitting and where you are missing. We will utilize publicly available CMS data, and data you supply us from your QPP Detailed Final Report, ACO, MA Plan(s), Electronic Medical Records (EHR) system, Practice Management System, and/or other manual sources. The RAF Verification Analysis requires the execution of a BAA.

You should expect to spend an hour or two working with our teams to extract the data points required. The research, analysis, and report efforts will take several manhours to complete on each analysis. Within two business days, we will be ready to discuss the finding and recommendations with you via Zoom calls (One for MIPS and one for RAF) and present the Optimization Strategy Reports. These reports will identify any compliance gaps & vulnerabilities and provide the most effective recommendations and solutions.

Our Provider Partners are the leading professional service providers and consulting firms that specialize in the processes of MIPS (QPP & MACRA), RAF Compliance, Health Information Exchange, and Patient Outreach Optimization for financial ROI.

They support thousands of independent and hospital-based physicians & clinicians, multi-TIN, Medicare Advantage plan providers, and ACO and Advanced APM members. And our MACRA & HIE expert Provider Partner is a CMS Certified Clinical Qualified Registry (a CMS approved entity that collects clinical data from MIPS clinicians (both individual and groups) and submits it to CMS on their behalf for purposes of MIPS. Reporting options are limited to measures within MIPS and the Quality Payment Program).

They are all specialists that possess knowledgeable teams of people that handle all necessary tasks, provide frequent reporting, and useful analysis.

In a 30-minute Zoom call, we will talk more about the RAF Verification Analysis and/or MIPS Category Weights Data Analysis and how much more revenue we can help you can capture.

Take a few moments to download our Provider Tune Up flyer, the CMS 2024 Rule Changes, the NQS, and our NCND. Complete and email it to: support@livewellaps.com. Then reserve your Zoom call with us.

1. Click Here to download the 2024 CMS RADV Final Rule Changes (pdf).
2. Click Here to download the 2024 CMS MIPS & PFS Final Rule Changes (zip).
3. Click Here to download the NQS 2024 (pdf).
4. Click Here to download our Mutual NCND (pdf).
5. Click Here to go to our Calendly page to reserve a Zoom call (complete the required fields and when asked “purpose of call,” click: Provider Tune Up).