KELLY R. RICHARDSON MD
NPI 1922184449
Internal Medicine - Clinical Cardiac Electrophysiology in Chattanooga, TN

Medicare Participation & PECOS Enrollment Status

Kelly Richardson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kelly Richardson 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.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

• Is the provider registered in PECOS? Yes

• PECOS PAC ID: 3678593985

  What is the PECOS Associate Control ID?
  A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

• PECOS Enrollment ID: I20181111000007

  What is the Provider Enrollment ID?
  The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

• 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 to Order or Refer Part B Clinical Laboratory and Imaging: Yes

• Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

• Eligible to Order or Refer a Home Health Agency (HHA): Yes

• Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Blood test, clotting time

A clotting time blood test helps determine how quickly your blood forms clots, a process crucial to stop bleeding. During the test, a small blood sample is taken from your arm. The sample is then analyzed in a lab to see how long it takes for a clot to form.

This service was performed 199 times for 30 patients

Comprehensive electrophysiologic evaluation with catheter destruction of abnormality causing atrial fibrillation (uncoordinated contraction of upper chambers of heart) by pulmonary vein isolation

This is a procedure to treat atrial fibrillation, a condition causing irregular heartbeats. It involves a detailed heart evaluation using electrophysiology. A catheter is then used to destroy the problematic area causing the issue. Specifically, isolation of the pulmonary vein is done to regulate the heartbeat.

This service was performed 22 times for 22 patients

Destruction of tissue of upper heart chamber through tube to treat abnormal heart rhythm

This procedure involves using a tube, or catheter, to access your upper heart chamber. Special tools are then used to destroy a small area of heart tissue causing abnormal rhythm. This helps reset your heart's regular rhythm, improving heart function.

This service was performed 18 times for 12 patients

Electrocardiogram (ecg) 2-day continuous with review by health care professional

An Electrocardiogram (ECG) is a test that checks your heart's activity. The 2-day continuous ECG records your heart's rhythm non-stop for 48 hours. It helps to detect irregularities that may not occur during a shorter test. A healthcare professional will review the results to identify any issues.

This service was performed 102 times for 96 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

This service was performed 17 times for 17 patients

Electrocardiogram (ecg) up to 30 days continuous with review and report by health care professional

An Electrocardiogram (ECG) is a non-invasive test that records the electrical signals in your heart. For up to 30 days, a small device will continuously monitor your heart's activity. A healthcare professional will then review the data and provide a report on your heart's function.

This service was performed 19 times for 19 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 18 times for 14 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 510 times for 365 patients

Established patient office or other outpatient visit, 40-54 minutes

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

This service was performed 42 times for 41 patients

Evaluation of cardiac rhythm monitor system

The evaluation of a cardiac rhythm monitor system involves checking your heart's electrical activity. It's a non-invasive procedure that uses a device to record your heart's rhythm and rate. This helps identify any irregularities, ensuring your heart is functioning properly.

This service was performed 25 times for 19 patients

Evaluation of cardiac rhythm monitor system, remote up to 30 days

This procedure involves remotely monitoring your heart rhythm for up to 30 days. A small device will record your heart's activity, which can be accessed by your healthcare team. This aids in diagnosing any irregularities or issues with your heart function.

This service was performed 214 times for 54 patients

Evaluation of implantable heart and blood vessel monitoring system

An evaluation of an implantable heart and blood vessel monitoring system involves checking the device that's placed inside your body to monitor your heart and blood vessels' health. It helps doctors track your heart rate, rhythm, and blood flow, aiding in prompt, accurate treatment.

This service was performed 88 times for 60 patients

Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days

This service involves remotely monitoring your heart and blood vessel implant system for up to 30 days. Using advanced technology, healthcare professionals can track the device's performance and your health status, ensuring the system is working optimally for your needs.

This service was performed 138 times for 62 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system

An evaluation of a pacemaker system examines how well your heart device is working. Single, dual, multiple lead, or leadless refers to the wires that deliver electrical pulses from the pacemaker to your heart. This check ensures your heart is receiving the right amount of support from the device.

This service was performed 28 times for 26 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days

This procedure involves remotely monitoring your pacemaker or implantable defibrillator system. Over a 90-day period, we check the device's performance and your heart's activity. This helps ensure the device is functioning properly and providing the best possible support for your heart health.

This service was performed 407 times for 186 patients

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days

This procedure evaluates your pacemaker system remotely for up to 90 days. It checks whether single, dual, multiple lead, or leadless pacemakers are working properly. It's a safe, convenient way to ensure your heart device is functioning optimally.

This service was performed 260 times for 124 patients

Evaluation of single, dual, or multiple lead implantable defibrillator system

This procedure evaluates your implantable defibrillator system, which helps regulate your heart rhythm. It can involve single, dual, or multiple lead systems. It's essential to ensure the device is working correctly and adjusting to your heart's needs.

This service was performed 17 times for 14 patients

Evaluation of single, dual, or multiple lead implantable defibrillator system, remote up to 90 days

This procedure involves remotely monitoring your implantable defibrillator system, which can have single, dual, or multiple leads. Over a period of up to 90 days, the system's performance is evaluated to ensure it's working properly and providing the necessary heart rhythm support.

This service was performed 137 times for 62 patients

External shock to heart to regulate heart beat

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

This service was performed 42 times for 38 patients

Follow-up hospital inpatient care per day, typically 25 minutes

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

This service was performed 113 times for 62 patients

Follow-up hospital inpatient care per day, typically 35 minutes

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

This service was performed 17 times for 16 patients

Heart rhythm review and interpretation of continous external ekg over 8-15 days

This service involves wearing a device for 8-15 days that continuously records your heart's electrical activity. It helps in identifying irregular heart rhythms. The recorded data is then reviewed and interpreted by a healthcare professional for any abnormalities.

This service was performed 206 times for 198 patients

Heart rhythm review, and interpretation of continous external ekg over more than 48 hours up to 7 days

A heart rhythm review involves monitoring your heart's electrical activity for more than 48 hours up to 7 days. Using a device called an external EKG, doctors can track your heartbeats to detect irregularities and help diagnose heart conditions.

This service was performed 71 times for 71 patients

Hospital observation care on day of discharge

Hospital observation care on the day of discharge involves monitoring your health status to ensure stability before you leave. This includes assessing vital signs, response to treatment, and readiness for home care or rehabilitation.

This service was performed 16 times for 16 patients

Initial hospital inpatient care per day, typically 50 minutes

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

This service was performed 13 times for 13 patients

Initial hospital inpatient care per day, typically 70 minutes

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

This service was performed 28 times for 27 patients

Insertion of catheters and destruction of tissue to treat abnormal heart rhythm

This procedure involves placing small tubes (catheters) into your heart via a blood vessel. These catheters emit energy that corrects irregular heartbeats by eliminating the problematic heart tissue. It's a common, minimally invasive method to treat abnormal heart rhythms.

This service was performed 15 times for 13 patients

Insertion of heart rhythm monitor under skin

The insertion of a heart rhythm monitor under the skin is a procedure to track your heart's activity. A small device is placed under your skin, recording your heart's rhythms continuously. This helps identify irregular heartbeats or conditions, aiding in your treatment.

This service was performed 22 times for 22 patients

Insertion of implantable defibrillator system

The insertion of an implantable defibrillator system is a procedure to manage irregular heart rhythms. A small device is placed under your skin, which monitors your heart rate. If it detects an abnormal rhythm, it sends an electrical pulse to restore normal heartbeat.

This service was performed 13 times for 13 patients

Insertion of pacemaker and upper and lower heart chamber electrode

A pacemaker insertion is a procedure where a small device, called a pacemaker, is implanted under your skin. This device uses electrical pulses to prompt the heart to beat at a normal rate. Electrodes are placed in the upper and lower chambers of your heart to help regulate your heartbeat.

This service was performed 18 times for 18 patients

Interrogation device evaluation(s), (remote) up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system, or subcutaneous cardiac rhythm monitor system, remote data acquisition(s), receipt of transmissions and tec

This procedure involves the remote monitoring of an implanted device in your heart for up to 30 days. The device collects data about your heart's function which is transmitted and analyzed. The goal is to track your heart's rhythm and identify any abnormalities.

This service was performed 230 times for 55 patients

New patient office or other outpatient visit, 45-59 minutes

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

This service was performed 73 times for 73 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 16 times for 16 patients

Pacemaker insertion or repair

Pacemaker insertion or repair is a procedure to help regulate your heartbeat. A small device, called a pacemaker, is implanted under the skin near your heart. This device sends electrical signals to prompt your heart to beat at a normal rate. In a repair procedure, the pacemaker may be adjusted, replaced, or the wires connecting it to your heart may be fixed.

This service was performed for 45 patients

Programming of dual lead implantable defibrillator system

Programming of a dual lead implantable defibrillator system involves adjusting settings on a device implanted in your chest. This device monitors your heart rhythm and delivers electrical pulses to correct irregular heartbeats, helping maintain a healthy heart rhythm.

This service was performed 29 times for 22 patients

Programming of dual lead pacemaker system

Programming of a dual lead pacemaker system is a procedure to adjust your heart's pacemaker settings. This process involves a small device, called a programmer, that communicates with your pacemaker to ensure it's working optimally for your heart's needs.

This service was performed 138 times for 106 patients

Programming of multiple lead implantable defibrillator system

Programming of a multiple lead implantable defibrillator system involves adjusting settings on your implanted device to help control irregular heart rhythms. The process is non-invasive and helps ensure optimal device performance for maintaining heart health.

This service was performed 52 times for 39 patients

Programming of single lead pacemaker system

Programming of a single lead pacemaker system involves adjusting the pacemaker's settings to suit your heart's unique needs. This is done using a special device that communicates with the pacemaker, ensuring it helps your heart beat at an optimal rate.

This service was performed 22 times for 19 patients

Repair of left upper heart chamber with implant with review by radiologist

This is a procedure to fix a problem in your left upper heart chamber. An implant is used to correct the issue. After the procedure, a radiologist, a doctor who specializes in medical imaging, reviews the images to ensure everything is in order.

This service was performed 30 times for 30 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

This service was performed 404 times for 324 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

This service was performed 103 times for 90 patients

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $30.45 for a new patient copayment and $23.4 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 37404 ZIP code area.

* The physician office visit costs information is generated by 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 provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 88.76, 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: .

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS 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.

• Final Score: 88.76 out of 100

  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.
  
  

• Quality Score: 90.58

  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 Score: 78.24

  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 Score: 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 activities measure category compromises 15% providers final MPIS scores.
  
  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 Score: 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.

• Cost Score: 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 Quality Measures

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Kelly Richardson is affiliated with the following medical facilities:

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NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

The NPI number 1922184449 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

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The following 20 providers are registered at the same or nearby location.

Frequently Asked Questions