QRDA1 files and the Providers linked to them.

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    • Type: QRDA-I Standard
    • Resolution: Done
    • Priority: Moderate
    • Component/s: None
    • None
    • Potential incorrect calculations when doing the Import/Calculate functionality.
    • MEDITECH
    • Michael Yearneau
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      Attribution guidance depends on the different reporting programs.
      If the QRDA I files were generated for MIPS individual reporting, then only the TIN/NPI combination for that eligible clinician/eligible practitioner should be used.
      If the QRDA I file is purposed for group reporting, then every TIN/NPI combination belonging to the group should be reported.
      Each CMS program has its own guidance for attribution, so it depends on which program you're submitting data to.
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      Attribution guidance depends on the different reporting programs. If the QRDA I files were generated for MIPS individual reporting, then only the TIN/NPI combination for that eligible clinician/eligible practitioner should be used. If the QRDA I file is purposed for group reporting, then every TIN/NPI combination belonging to the group should be reported. Each CMS program has its own guidance for attribution, so it depends on which program you're submitting data to.

      Here is my understanding of QRDA1 creation. When the file is created it should contain all the patient's data related to the eCQMs defined for it. The file will then have a Tax Identification Number and Provider NPI associated with it. We have always created a QRDA1 file for every TIN/NPI/Patient combination we get from running the eCQMs. This has always meant that things such as encounters could be included in a QRDA1 file that were not performed under the TIN/NPI linked to the QRDA1 document. Is this all correct? If so, I would also have a question about what to do when importing QRDA1 files for calculation. As far as I am aware the only way to assign a performer to encounters within a QRDA1 is the the main one linked to the document itself. To me this would mean that encounters not performed by that Provider would be counted as though they did. Is there any clarification you can provide on this?

            Assignee:
            Yan Heras
            Reporter:
            Michael Yearneau
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              Created:
              Updated:
              Resolved: