Alternative Process for Individual Eligible Professionals to Access Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing (E-Prescribing) Feedback Reports
MLN Matters® Number: SE0922
Related Change Request (CR) #: N/A
Related CR Release Date: N/A
Effective Date: N/A
Related CR Transmittal #: N/A
Implementation Date: N/A
Provider Types Affected
Individual Eligible Professionals (EPs) requesting reports based on their individual National Provider Identifier (NPI) have an alternative means of accessing those reports. Physicians and other practitioners who qualify as individual EPs under the Centers for Medicare & Medicaid Services (CMS) Physician Quality Reporting Initiative (PQRI) and the 2009 E-Prescribing Incentive Program can request feedback reports through their claims processing contractor. The MLN Matters article (MM6394) listing individual EPs under these incentive programs may be found at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6394.pdf on the CMS website.
What You Need to Know
- CMS has created an alternative process that individual EPs may use to request 2007 Re-Run and 2008 PQRI feedback reports based on their individual NPI.
- Based on the nature of your questions (e.g., status of your PQRI incentive payment, measures, coding, or the feedback reports), you may need to contact different entities.
- E-Prescribing feedback reports for data submitted in calendar year 2009 will be available in late 2010. CMS will notify EPs when they can begin requesting these reports using this alternative process.
You should make sure your billing staffs are aware of this information. Please refer to the information below for more details.
Background
In the past, EPs could only access PQRI feedback reports through a secure website after first registering in the CMS security system known as Individuals Authorized Access to the CMS Computer Services (IACS). CMS is now offering an alternative feedback report request process which will be available beginning October 19, 2009. This new process eliminates the need for individual EPs to register in IACS for their feedback report.
Alternative PQRI Feedback Report Request Process for Individual EPs
Beginning on October 19, 2009, individual EPs can call their respective carrier or A/B MAC Provider Contact Center to request 2007 Re-Run and 2008 PQRI feedback reports that will contain data based on their individual NPI. This means that EPs who are part of a group practice can get their individual feedback reports as well.
Beginning on October 19, 2009, individual EPs can call their respective carrier or A/B MAC Provider Contact Center to request 2007 Re-Run and 2008 PQRI feedback reports that will contain data based on their individual NPI. This means that EPs who are part of a group practice can get their individual feedback reports as well.
When requesting feedback reports, EPs will be asked to provide an e-mail address. EPs can then expect to receive the e-mailed feedback report within 30 days of the request. If no report is available, the provider will receive an e-mail notification.
EPs Requesting Reports Based on Taxpayer Identification Number (TIN) for Group Practice Information
EPs who request feedback reports based on TIN or group practice information will still be required to access their PQRI feedback reports via the PQRI Portal after first registering in IACS. An IACS user identification and password is required to access the PQRI Portal. The PQRI Portal may be found at http://www.qualitynet.org/pqri.
Correct Contact Based on Questions
CMS has provided the following resources to answer your questions about the PQRI and E-Prescribing programs, incentive payments, feedback reports, and IACS registration and account issues.
1. A/B MAC and Carrier Provider Contact Centers can answer questions concerning incentive payment status, such as:
- Was my incentive payment sent?
- What is my incentive payment amount?
- What does my Remittance Advice(s) mean?
2. Quality Net Help Desk can provide general PQRI and E-Prescribing information as well as answer questions about PQRI feedback report availability and access, coding, measures, and the feedback reports themselves. Examples of questions they can assist with include:
- Do I have a PQRI feedback report available for this TIN or NPI?
- When will my PQRI feedback reports be available?
- Why am I unable to view my PQRI feedback report on the PQRI Portal?
- Did I qualify for a PQRI incentive payment?
- When will my PQRI incentive payment be available?
- Can you explain a specific part of my PQRI feedback report?
Contact the QualityNet Help Desk Monday – Friday from 7:00 a.m. - 7:00 p.m. CST at 1-866-288-8912 or by email: qnetsupport@sdps.org.
3. External User Services (EUS) can resolve issues concerning IACS registration and account issues such as:
- I need help registering in IACS;
- I need help accessing my IACS account;
- I need help changing my IACS account; and,
- I need help approving users in my organization.
Contact EUS at 1-866-484-8049 Monday – Friday from 7:00 a.m. - 7:00 p.m. EST or by email: EUSsupport@cgi.com.
Additional Information
Please remember that EP and group practice provider enrollment information must be current in the Medicare Provider Enrollment Chain and Ownership System (PECOS) in order to request an IACS account. An IACS account is needed to access the PQRI Portal and view or download TIN-level PQRI feedback reports.
There are other sources where you can find additional information.
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents. CPT only copyright 2008 American Medical Association.