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Type:
EC eCQMs - Eligible Clinicians
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Resolution: Answered
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Priority:
Moderate
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Component/s: None
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None
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Kimberly Watson
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8137749800
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DAS Health
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CMS0050v13
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Score earned because of the referral assignment is lower than anticipated.
In reviewing the 2025 specifications for CMS 50 Closing the Referral loop, I was wondering if a practice has documented a referral for a physician (provider A) with a multi-provider practice, and that patient is seen by a different physician (provider B) within that same physician group; is the referring provider still able to obtain credit for this instance, once the consultation report has been completed? We are coming across a discrepancy in our EHR and want to understand if credit is still warranted. The eCQI only provides the following: Referral: A request from one clinician to another clinician for evaluation, treatment, or co-management of a patient's condition. This term encompasses referral and consultation as defined by Centers for Medicare & Medicaid Services. Report: A written document prepared by the eligible clinician (and staff) to whom the patient was referred and that accounts for his or her findings, provides summary of care information about findings, diagnostics, assessments and/or plans of care, and is provided to the referring eligible clinician. The clinician who refers the patient to another clinician is the clinician who should be held accountable for the performance of this measure. Any additional clarification you could provide would be greatly appreciated,