[CQM-6690] Need clarification on payer. Created: 01/11/24 Updated: 01/16/24 Resolved: 01/16/24 |
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| Status: | Closed |
| Project: | eCQM Issue Tracker |
| Component/s: | None |
| Type: | EC eCQMs - Eligible Clinicians | Priority: | Moderate |
| Reporter: | Mujtaba Hussayn (Inactive) | Assignee: | Mathematica EC eCQM Team |
| Resolution: | Answered | Votes: | 0 |
| Labels: | None | ||
| Solution: | Thank you for your question regarding CMS68v12 Documentation of Current Medications in the Medical Record. This measure captures all insurances/payers for qualifying encounters that fulfill measure requirements. While the measure does capture payer as a supplemental data element, there are no requirements that a patient have a given insurance or payer to be captured in the measure.
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| Solution Posted On: | |
| 2024 Performance Period EC eCQMs: |
CMS0068v13
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| Description |
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Do patients need to have Medicare, Medicaid, or Other (Typology) primary payer insurance to meet the eCQM criteria? Alternatively, does having secondary or tertiary insurance from these specified typolgies, still fulfill the criteria? or we need to check the primary insurance only for fulfilling the criteria? |
| Comments |
| Comment by Mathematica EC eCQM Team [ 01/12/24 ] |
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Thank you for submitting your question. We will review your ticket and provide a response as soon as possible. |