ERIK M RATCHFORD D.O. NPI 1003013392
Urology in Grand Rapids, MI
About ERIK M RATCHFORD D.O.
Erik Ratchford is a provider established in Grand Rapids, Michigan and his medical specialization is Urology with more than 16 years of experience. He graduated from Michigan State University College Of Osteopathic Medicine in 2007. The NPI number of this provider is 1003013392 and was assigned on June 2007. The practitioner's primary taxonomy code is 208800000X with license number 5101017248 (MI). The provider is registered as an individual and his NPI record was last updated one year ago.
| NPI | 1003013392 |
| Provider Name | ERIK M RATCHFORD D.O. |
| Location Address | 245 CHERRY ST SE, SUITE 202 GRAND RAPIDS, MI 49503 |
| Location Phone | (616) 459-3551 |
| Mailing Address | 245 CHERRY ST SE, SUITE 202 GRAND RAPIDS, MI 49503 |
| Gender | Male |
| NPI Entity Type | Individual |
| Medical School Name | MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE |
| Graduation Year | 2007 |
| Is Sole Proprietor? | No |
| Enumeration Date | 06-29-2007 |
| Last Update Date | 03-21-2022 |
Erik Ratchford is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Erik Ratchford is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data he has hospital affiliations with .
The provider participated in Medicare's Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 63.3, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance. The provider also has detailed performance information the following quality measures: biopsy follow-up, documentation of current medications in the medical record, implementation of formal quality improvement methods, practice changes, or other practice improvement processes, measurement and improvement at the practice and panel level, participation in a qcdr, that promotes collaborative learning network opportunities that are interactive., participation in a qcdr, that promotes use of patient engagement tools., participation in moc part iv, participation in population health research and use of qcdr data for ongoing practice assessment and improvements.
The typical physician office visit costs for Medicare beneficiaries in this area are: $32.68 for a new patient copayment and $17.7 for an established patient copayment.
Primary Taxonomy
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
| Taxonomy Code | 208800000X |
| Classification | Urology |
| Type | Allopathic & Osteopathic Physicians |
| License No. | 5101017248 |
| License State | MI |
| Taxonomy Description | A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Business Address
245 CHERRY ST SE,
SUITE 202
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 459-3551
Fax: (616) 459-1060
Mailing Address
245 CHERRY ST SE,
SUITE 202
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 459-3551
Fax: (616) 459-1060
Location Map
PECOS Enrollment and Medicare Participation Status
What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
| Registered in PECOS? | Yes |
| PECOS PAC ID | 9931355088 |
| PECOS Enrollment ID | I20120806000885 |
| Accepts Medicare Assignment? | Yes "What does it mean "accepts medicare assignment"? When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts. A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer. |
| Eligible order / refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible order / refer Durable Medical Equipment | Yes |
| Eligible order / refer Home Health Agency (HHA) | Yes |
| Eligible order / refer Power Mobility Devices | Yes |
Physician Office Visit Costs
The provider accepts as payment the Medicare approved amount. Medicare beneficiaries should not be billed for more than the Medicare deductible and coinsurance amounts. Medicare pricing is usually a reference point for private insurance covered patients. The prices below reflect the costs for new and established patients in the 49503 ZIP code area.
| New Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for new patients office visits: 99204 | ||
| Minimum New Patient Pricing | Maximum New Patient Pricing | Typical New Patient Pricing |
| $56.39 | $172.8 | $130.74 |
| Minimum New Patient Copayment | Maximum New Patient Copayment | Typical New Patient Copayment |
| $14.09 | $43.2 | $32.68 |
| Established Patients Office Visits Costs * | ||
|---|---|---|
| Most Utilized Procedure Code for established patients office visits: 99213 | ||
| Minimum Established Patient Pricing | Maximum Established Patient Pricing | Typical Established Patient Pricing |
| $17.24 | $140.86 | $70.8 |
| Minimum Established Patient Copayment | Maximum Established Patient Copayment | Typical Established Patient Copayment |
| $4.31 | $35.21 | $17.7 |
* The physician office visit costs information is obtained by Medicare's statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in Medicare's Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
| MIPS Measure | Score Weight | Score | |
|---|---|---|---|
| Quality | 40% | 56.8 | |
|
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores. There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey. |
|||
| Promoting Interoperability (PI) | 25% | N/A | |
|
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores. The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. |
|||
| Improvement Activities | 15% | 40 | |
|
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. |
|||
| Cost | 20% | N/A | |
|
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services. Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. |
|||
| MIPS Final Score | - | 63.3 | |
| The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment. | |||
MIPS Quality Measures
The following performance measures were reported under the Merit-Based Incentive Payment System (MIPS) and Qualified Clinical Data Registry (QCDR) quality measures program.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Biopsy Follow-Up | 84% | 37 |
| Percentage of new patients whose biopsy results have been reviewed and communicated to the primary care/referring physician and patient. | ||
| Documentation of Current Medications in the Medical Record | 95% | 38 |
| Percentage of visits for patients aged 18 years and older for which the MIPS eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration. | ||
| Implementation of formal quality improvement methods, practice changes, or other practice improvement processes | Yes | N/A |
| Adopt a formal model for quality improvement and create a culture in which all staff actively participates in improvement activities that could include one or more of the following, such as:- Participation in multisource feedback;- Train all staff in quality improvement methods;- Integrate practice change/quality improvement into staff duties;- Engage all staff in identifying and testing practices changes;- Designate regular team meetings to review data and plan improvement cycles;- Promote transparency and accelerate improvement by sharing practice level and panel level quality of care, patient experience and utilization data with staff;- Promote transparency and engage patients and families by sharing practice level quality of care, patient experience and utilization data with patients and families, including activities in which clinicians act upon patient experience data;- Participation in Bridges to Excellence;- Participation in American Board of Medical Specialties (ABMS) Multi-Specialty Portfolio Program. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following:- Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or- Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive. | Yes | N/A |
| Participation in a QCDR, that promotes collaborative learning network opportunities that are interactive. | ||
| Participation in a QCDR, that promotes use of patient engagement tools. | Yes | N/A |
| Participation in a Qualified Clinical Data Registry (QCDR), that promotes patient engagement, including:- Use of processes and tools that engage patients for adherence to treatment plans;- Implementation of patient self-action plans;- Implementation of shared clinical decision making capabilities; or- Use of QCDR patient experience data to inform and advance improvements in beneficiary engagement. | ||
| Participation in MOC Part IV | Yes | N/A |
| In order to receive credit for this activity, a MIPS eligible clinician must participate in Maintenance of Certification (MOC) Part IV. Maintenance of Certification (MOC) Part IV requires clinicians to perform monthly activities across practice to regularly assess performance by reviewing outcomes addressing identified areas for improvement and evaluating the results.Some examples of activities that can be completed to receive MOC Part IV credit are: the American Board of Internal Medicine (ABIM) Approved Quality Improvement (AQI) Program, National Cardiovascular Data Registry (NCDR) Clinical Quality Coach, Quality Practice Initiative Certification Program, American Board of Medical Specialties Practice Performance Improvement Module or American Society of Anesthesiologists (ASA) Simulation Education Network, for improving professional practice including participation in a local, regional or national outcomes registry or quality assessment program; specialty- specific activities including Safety Certification in Outpatient Practice Excellence (SCOPE); American Psychiatric Association (APA) Performance in Practice modules. | ||
| Participation in Population Health Research | Yes | N/A |
| Participation in federally and/or privately funded research that identifies interventions, tools, or processes that can improve a targeted patient population. | ||
| Use of QCDR data for ongoing practice assessment and improvements | Yes | N/A |
| Participation in a Qualified Clinical Data Registry (QCDR) and use of QCDR data for ongoing practice assessment and improvements in patient safety, including:- Performance of activities that promote use of standard practices, tools and processes for quality improvement (for example, documented preventative screening and vaccinations that can be shared across MIPS eligible clinician or groups);- Use of standard questionnaires for assessing improvements in health disparities related to functional health status (for example, use of Seattle Angina Questionnaire, MD Anderson Symptom Inventory, and/or SF-12/VR-12 functional health status assessment);- Use of standardized processes for screening for social determinants of health such as food security, employment, and housing;- Use of supporting QCDR modules that can be incorporated into the certified EHR technology; or- Use of QCDR data for quality improvement such as comparative analysis across specific patient populations for adverse outcomes after an outpatient surgical procedure and corrective steps to address adverse outcomes. | ||
Clinician Utilization
The following Healthcare Common Procedure Coding System (HCPCS) codes were publicly reported as the top services rendered by this provider under the Medicare program for the year 2017. The reported codes are based on the top 5 codes for each available Medicare specialty, excluding evaluation and management codes.
- 343Ultrasound measurement of bladder capacity after voiding (HCPCS:51798)
- 73Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope (HCPCS:52000)
- 38Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
- 13Ultrasound of rectum (HCPCS:76872)
- 11Ultrasonic guidance imaging supervision and interpretation for insertion of needle (HCPCS:76942)
- 11Biopsy of prostate gland (HCPCS:55700)
NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 0 | 3 | 0 | 1 | 3 | 3 | 9 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 0 | 3 | 0 | 1 | 6 | 3 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 0 + 3 + 0 + 1 + 6 + 3 + 1 + 8 + 24 = 48 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 48 = 2 | 2 | ||||||||
The NPI number 1003013392 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
What is Erik Ratchford D.O. NPI number?
The NPI number assigned to this healthcare provider is 1003013392, registered as an "individual" on June 29, 2007
Where is Erik Ratchford D.O. located?
The provider is located at 245 Cherry St Se, Suite 202 Grand Rapids, Mi 49503 and the phone number is (616) 459-3551
Which is Erik Ratchford D.O. specialty?
The provider's speciality is Urology
How many years of experience does Erik Ratchford D.O. have?
The provider has more than 16 years of experience. He graduated from Michigan State University College Of Osteopathic Medicine in 2007.
Is Erik Ratchford D.O. registered in PECOS?
Yes, as of March 13, 2023 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a Medicare beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What are Erik Ratchford D.O. Quality Ratings?
The provider obtained a high score in the following performance measures: Documentation of Current Medications in the Medical Record. The quality ratings are based on unbiased reviews and reported submissions to Medicare's Quality Payment Program.
How much is a visit to Erik Ratchford D.O.?
Medicare beneficiaries should expect a typical cost of $130.74 with an average copayment of $32.68 for new patient appointments. Established patients should expect a typical charge of $70.8 and an average copayment of 17.7. Please review your insurance plan or contact the provider directly to determine your specific costs.
What are some of the services provided by Erik Ratchford D.O.?
The most common procedures or services performed by this practitioner are: Ultrasound measurement of bladder capacity after voiding, Diagnostic examination of the bladder and bladder canal (urethra) using an endoscope, Injection beneath the skin or into muscle for therapy, diagnosis, or prevention, Ultrasound of rectum, Ultrasonic guidance imaging supervision and interpretation for insertion of needle and Biopsy of prostate gland.
How do I update my NPI information?
The NPI record of Erik Ratchford D.O. was last updated on June 29, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected]
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.