Retina PractiCare

Turning Claims Into Intelligence

The American Society of Retina Specialists’ Retina PractiCare is the go-to resource for data on how your practice compares with national and regional trends. Practice-specific Retina PractiCare reports can help you determine changes in coding and billing to avoid costly audits and recoupments, bolster negotiating power with payers, and strengthen arguments against comparisons with comprehensive ophthalmologist.

Retina PractiCare is the only HIPAA compliant benchmarking tool based solely on claims from retina practices that:

  • Analyzes healthcare service utilization trends
  • Establishes normative practice and coding patterns
  • Provides retina-specific data for responding to insurers’ efforts to create “efficiency” in practice

The complimentary member service is compatible with most practice management systems and easy to use. Check out the PractiCare Resources page for a list of confirmed compatible practice management systems. When you enroll, ASRS will work with you to get your practice up and running with Retina PractiCare quickly.

Workflow overview

Retina PractiCare enables practices to benchmark a variety of metrics against the regional and national averages. The graphic to the right shows a basic model (click the graphic to enlarge).

ASRS provides participants with a tool that extracts data from your claims files or Excel-based report, removes the protected health information (PHI) from the extrated information, and submits the PHI-free extracted data to secure AWS GovCloud servers. The data from praticipating practices is aggregated and analyzed to create practice-specific reports for participants that illustrate the practice's* and its individual physician's performance* against the national and regional trends.
*Practice-level reports only contain practice-specific data for that practice and it's individual physicians. Your practice-specific information is not shared with other participants.

See a list of Retina PractiCare report analyses (login required)

How to get started

  1. Complete the enrollment form (login required)
  2. Watch for an enrollment confirmation email
  3. Check with ASRS to determine if your practice managment software provides access to claims information and the best way for your practice to submit data  
  4. Watch for a follow-up email containing the Retina PractiCare Instruction Guide and your practice's credentials (username, password, and practice ID)
  5. Schedule a live, web-based training, at your convenience
  6. Download the Retina PractiCare Data De-identification and Submission tool through the instruction guide and start using Retina PractiCare

Start using Retina PractiCare

  1. On your computer, locate and take note of the folder where your claims management software saves your CMS-837 files or your Excel-based report
  2. Open the user guide that accompanied your credentials, click on the URL to download the Retina PractiCare Data De-identification and Submission Tool, and follow the steps in the user guide for setting up the Tool
  3. With the user guide in-hand, follow the Tool's guided process for de-identfying your claims data and submitting the protected health information-free data to ASRS's secure AWS GovCloud servers
  4. Email Caroline Bozell to confirm that your first batch of claims files successfully uploaded
  5. Watch for your practice-specific report from ASRS

Participating practices should watch ASRS for official data submission deadlines. Practice-level reports will generally arrive a few weeks after a submission deadline.

Next Retina PractiCare Data Submission Deadline: July 25, 2016

Please upload your 1st and 2nd quarter 2016 practice data.

Questions about Retina PractiCare?

Consult the Retina PractiCare FAQ and/or contact Caroline Bozell at caroline.bozell@asrs.org or 312-578-8760.

Problems with a submission?

Please contact Caroline Bozell if you are experiencing any issues using the Retina PractiCare Tool.

Expert Overview

Retina PractiCare is made possible by contributions from Allergan and
 Regeneron Pharmaceuticals, Inc.