CMS50v13 Closing the Referral Loop

XMLWordPrintable

    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Answered
    • Priority: Moderate
    • Component/s: None
    • None
    • 530-623-2687 ext. 5012
    • Billy Rogers
    • Hide
      Thank you for inquiring about the Closing the Referral Loop: Receipt of Specialist Report eCQM. Based on the scenario described, you will want to work with your EHR vendor/measure reporting vendor to make sure that your documentation correction process is correctly reflected in the data that they are pulling for measure analysis. The ordered concept used in the measure does not consider completion, but rather the intent or request for something to be done. If documentation corrections are in the record (e.g., similar to what would be anticipated if a provider documented on the wrong patient’s record), then the data retrieval should reflect the correct patient documentation.
      Show
      Thank you for inquiring about the Closing the Referral Loop: Receipt of Specialist Report eCQM. Based on the scenario described, you will want to work with your EHR vendor/measure reporting vendor to make sure that your documentation correction process is correctly reflected in the data that they are pulling for measure analysis. The ordered concept used in the measure does not consider completion, but rather the intent or request for something to be done. If documentation corrections are in the record (e.g., similar to what would be anticipated if a provider documented on the wrong patient’s record), then the data retrieval should reflect the correct patient documentation.
    • CMS0050v13

      Hello, We are working on our ECQMs and one of them that we are having issues with is CMS50v13. We have noticed that a lot of our patient population has referrals that are counting against us. We have noticed that if there is any referral that is put in and the Patient, Doctor Office, or Insurance declines the referral, they only count in the Denominator. For example, in the patient's chart you can see that we went in and deleted the initial referral to an Orthopedic office. The patient declined to go there, so we deleted that referral. We then put in a new referral to Shasta Ortho (different ortho company) because that is where the patient wanted to go. Everything we did was sufficient to complete the measure specifications gave to us by our EHR Vendor, yet the are still counting in the denominator only. Even though we received a report and added in the information for the second referral, it still is saying this patient is in the Denominator Only. Please let me know if you have any questions. I might be able to explain better over the phone than through the ticket.

            Assignee:
            AIR EC eCQM Team
            Reporter:
            William Rogers
            Votes:
            0 Vote for this issue
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved:
              Solution Posted On: