MIPS Reporting Services for the Quality Payment Program, Handled for You

Medicare adjusts your Part B payments based on a quality score you earn two years earlier. Our MIPS reporting services collect your data, check it against your claims, and submit it before the deadline. You keep seeing patients while we manage the paperwork.

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MIPS Reporting Services for US Practices | Mediflows

What Is the Quality Payment Program, and Where Does Billing Fit In?

The Quality Payment Program (QPP) is how Medicare ties Part B payments to the quality of care you report. Most independent practices take part through the Merit-based Incentive Payment System, known as MIPS. Your score in one year changes your payment rate two years later.

Billing sits at the center of it. Quality codes ride on your claims, and the data behind your score has to match what you billed. That is why a billing team is a natural fit to run MIPS.

How Does MIPS Reporting Connect to Your Claims and Your EHR?

MIPS data comes from several places. If those sources disagree, your score suffers. We line them up for you.

Quality measure data pulled from your EHR or registry
Quality data codes added to Medicare Part B claims where a measure needs them
Promoting Interoperability attestations tied to your EHR use
Improvement activity records, with proof saved for audit
Cost results, which CMS calculates from your claims without a separate submission

Every one of these touches billing or your clinical system. We keep them consistent from January to submission.

What Our MIPS Reporting Services Cover

Eligibility checks for each clinician and group
Measure selection based on your specialty and patient mix
Data collection, validation, and submission support
Score tracking with mid-year alerts
Documentation kept ready in case CMS asks for it

What a Missed MIPS Deadline Can Cost Your Practice

What Goes Wrong	What It Can Mean	Who Is Affected
No Data Submitted	A negative payment adjustment on Medicare Part B claims.	Every eligible clinician in the practice.
Weak Measure Choices	A low performance score, even when data has been reported.	Practices that select measures at the last minute.
Missing Proof for Activities	Potentially lost points if CMS reviews the submitted data.	Practices without saved supporting documentation.
Late Hardship Request	An exception may no longer be available after the deadline.	Practices experiencing EHR problems or natural disasters.

Important: Payment adjustment amounts, eligibility requirements, and deadlines can change each performance year. Visit the official CMS Quality Payment Program website to verify the current rules and requirements.

MIPS in Revenue Cycle

Where MIPS Work Sits in the Revenue Cycle

Front end

We confirm which clinicians must report and pick measures before the year builds momentum.

Claim submission

Quality data codes go on claims where the measure calls for them.

Payment posting and A/R

We watch Medicare payments for adjustments tied to your past performance.

Reporting

We validate the data and submit it inside the CMS window.

How We Run MIPS From Year Start to Data Submission

Here is the path we follow with every practice.

Step 01 of 06

We Confirm Who Has to Report

We check each clinician’s Medicare enrollment, specialty, and volume against current CMS rules.

Step 2 of 06

We Choose Measures That Fit Your Patients

We match quality measures to what your practice actually treats, so you can report them accurately.

Step 03 of 06

We Set Up the Data Flow

We connect your EHR, registry, and claims so the right data reaches the right place.

Step 04 of 06

We Track Your Score During the Year

You get regular updates on how you are doing, so gaps show up in spring, not the next winter.

Step 05 of 06

We Fix Gaps While There Is Still Time

If a provider note is missing, a payer asks for records, or a payment looks short, we tell you the same day we find it, with what we need to fix it.

Step 06 of 06

We Submit and Keep the Records

We submit during the CMS window and save a copy of your data and proof. After CMS posts your results, we review your feedback report with you.

What We Need From You to Get Started

Having these ready before you start is the single biggest thing you can do to speed up coding.

Access

Information

Common MIPS Mistakes and the Task That Catches Each One

Mistake	How It Happens	Our Fix
Reporting the Wrong Clinicians	Staff changes go untracked throughout the year.	Quarterly eligibility checks.
Measures with Low Data Volume	Measures are selected without reviewing the patient mix.	Measure review before the performance year begins.
Claims Missing Quality Codes	Billing staff are not informed about applicable measures.	Billing alerts aligned with your selected measures.
Evidence Not Saved	Supporting records remain in one person’s inbox.	A centralized documentation file.

Situations Where Practices Hand Off MIPS Reporting

Situation 01 of 05

A Small Practice With No One Tracking MIPS

Two providers share front-desk duties. Nobody owns MIPS, so it gets looked at in March. We take it over in January.

Situation 02 of 05

A Practice That Got a Payment Adjustment Notice

A manager sees a lower Medicare rate and does not know why. We review the feedback report and find the cause.

Situation 03 of 05

A Group That Added Clinicians Mid-Year

New providers join, and group reporting needs to change. We update the roster and the data plan.

Situation 04 of 05

A Practice That Switched EHRs

Data does not carry over cleanly. We rebuild the reporting path and test it before submission.

Situation 05 of 05

A Specialty Practice With Few Fitting Measures

A surgical or therapy group struggles to find measures that apply. We review the options and pick the best fit.

Should You Report MIPS In-House, With Your EHR Vendor, or With Us?

Comparison	In-house Staff	EHR Vendor Tools	Mediflows
Who Tracks the Score	One employee, if available	You, from a dashboard	Our team, with updates to you
Claims and Quality Data Matched	Manual	Often not covered	Part of the billing workflow
Cost	Salary and training	Software fees	Percentage-based fee
Coverage if Staff Leave	Gaps	Unchanged	Team backup

Reporting That Is Ready Before the Deadline

MIPS works best when someone watches it all year. We do that so you do not have to learn the rules every winter. Tell us where you are stuck, and we will show you how we would handle it.

Which Practices Benefit Most From Outsourced MIPS Support?

Independent practices with Medicare Part B patients
Small groups without a compliance person
Practices adding providers
Practices that changed EHRs recently
Specialists unsure which measures apply
Practices that received a negative adjustment
Managers tired of tracking deadlines in spreadsheets

If one of these sounds like you, a short review will show whether we are a fit.

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Free Billing Consultation— on Your MIPS Reporting

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FAQs About MIPS Reporting Services

Who has to report MIPS?

Most clinicians who bill Medicare Part B above CMS volume thresholds must take part. Thresholds and eligible clinician types change by year, so check qpp.cms.gov for the current rules.

What happens if you do not report MIPS?

You can receive a negative payment adjustment on your Medicare Part B payments two years later. The size depends on the program rules for that year.

When is the MIPS submission deadline?

CMS usually closes data submission in the spring after the performance year ends. The date can change, so we confirm it each year.

Do you guarantee a positive payment adjustment?

No. Your score depends on your care data and CMS rules. We help you report completely and accurately.