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  1. eCQM Issue Tracker
  2. CQM-816

Patients with Multiple Payers

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      How to report a patient with multiple payers is specified in the CMS Eligible Professionals Programs Quality Reporting Document Architecture Category III, Release 1, Implementation Guide for 2014, Volume 2 – Templates and Supporting Materials (Version 2.0, 04/18/2014). On page 43 of this implementation guide, it has the following statement, “When a patient has multiple payers, only count the primary payer (usually this is the first payer listed).”

      http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/QRDA_III_CMS_EP_2014_IG_Vol1.zip
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      How to report a patient with multiple payers is specified in the CMS Eligible Professionals Programs Quality Reporting Document Architecture Category III, Release 1, Implementation Guide for 2014, Volume 2 – Templates and Supporting Materials (Version 2.0, 04/18/2014). On page 43 of this implementation guide, it has the following statement, “When a patient has multiple payers, only count the primary payer (usually this is the first payer listed).” http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/QRDA_III_CMS_EP_2014_IG_Vol1.zip

      We noticed that the Cypress test data does not consider the issue of multiple payers for one patient, but in the real world it happens all the time.

      Is our assumption correct, that since individual patients might have multiple payers, the total of all counts from payer sections could be greater than the total patient count?

            yanheras Yan Heras
            gmagazu Gregory Magazu (Inactive)
            Bob Dolin (Inactive), Gregory Magazu (Inactive), Kevin Larsen (Inactive), Rabia Khan (Inactive), Renee Rookwood (Inactive), Robert Dingwell (Inactive)
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