Preparing Data Validation Plan when you go as QCDR(Qualified Clinical Data Registry) or Qualified Registry for MIPS Reporting

In 2015, the US Senate voted (98-2) to permanently repeal the highly criticized Medicare Part B Sustainable Growth Rate (SGR) reimbursement formula and passed the “Medical Access and CHIP Reauthorization Act of 2015” (MACRA) creating a new, pay-for-performance oriented Medicare reimbursements program. The program, called the Merit-Based Incentive Payment System (MIPS), will have a significant effect on reimbursement.

This was a hectic season for us as last submission date for registering as QCDR or Qualified registry with CMS was 15th of Jan 2017. CMS has provided self nomination form which has to be completed with every detail so that you can be reviewed and evaluated before getting approved. A lot of information been available from QPP website

A qualified registry is an entity that collects clinical data from an individual MIPS clinician or group practice and submits it to CMS on behalf of the clinicians. Clinicians work directly with their chosen registry to submit data on the selected measures or specialty set of measures. One must provide information on your process for data validation for both individual MIPS eligible clinicians and groups within a data validation plan.

Few of key things that one need to elaborate were

  • Data Capture Methods
  • Method for Verifying TINs and NPIs
  • Method for Calculating Performance Rates for Quality Measures (source of clinician’s data)
  • Method for Calculating Performance Data for Improvement Activities and Advancing Care Information (source of clinician’s data)
  • Randomized Audit Process
  • Data Validation Process
  • Data Validation Results

THOUGHTi consultants helped our clients to prepare every detail and guided to form process so that maximum attention is given to abide by all criteria and at the same time minimum effort/trouble for participating providers(EPs, Group Practices & EHs)

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