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  2. CQM-5469

Quality Measure 374

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    • Jennifer Manning
    • 406-756-7555, ext. 3206
    • Dermatology Associates
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      ​Thank you for your question regarding CMS50v11: Closing the Referral Loop: Receipt of Specialist Report. The receipt of the consultant report from the specialist to whom the patient was referred is the only criteria necessary for the patient to be included in the numerator, regardless of the content of the report (see relevant measure logic below). If you receive a consultant report from the specialist to document that the patient either 1. decides not to schedule with the specialist, 2. does not respond to calls from the specialist, or 3. no-shows to their scheduled appointment(s), the necessary criteria should be met for the measure.

      ​

      Initial Population
       
      "Has Encounter during Measurement Period"
        and "First Referral during First 10 Months of Measurement Period" is not null

       
       
      Denominator
       
      "Initial Population"


       
      Numerator
       
      "Referring Clinician Receives Consultant Report to Close Referral Loop"

       
      Show
      ​Thank you for your question regarding CMS50v11: Closing the Referral Loop: Receipt of Specialist Report. The receipt of the consultant report from the specialist to whom the patient was referred is the only criteria necessary for the patient to be included in the numerator, regardless of the content of the report (see relevant measure logic below). If you receive a consultant report from the specialist to document that the patient either 1. decides not to schedule with the specialist, 2. does not respond to calls from the specialist, or 3. no-shows to their scheduled appointment(s), the necessary criteria should be met for the measure. ​ Initial Population   "Has Encounter during Measurement Period"   and "First Referral during First 10 Months of Measurement Period" is not null     Denominator   "Initial Population"   Numerator   "Referring Clinician Receives Consultant Report to Close Referral Loop"  
    • CMS0050v11
    • I am needing some clarification on quality measure 374.

      I have a question regarding quality measure 374: Closing the Referral Loop: Receipt of Specialist Report. If one of our providers refers a patient to a specialist and the patient either 1. decides not to schedule with the specialist, 2. does not respond to calls from the specialist, or 3. no-shows to their scheduled appointment(s), would it count as favorable for this measure if we receive documentation from the specialist's office showing this applicable information? In other words, we would complete the communication loop by showing the patient was not seen by the specialist and documentation on the reason why not. 

      Thank you for your help.

            edave Mathematica EC eCQM Team
            jmanning Jennifer Manning
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