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Steps for Eligible Professionals to Access Their Physician Quality Reporting Initiative (PQRI) Feedback Reports

MLN Matters Number: SE0830 Revised
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
 
 
Note: This article was revised on November 25, 2008, to provide clarification of some of the steps involved in registration and to clarify who can register as individual practitioners.
 
Provider Types Affected
This document is directed to individual eligible professionals who reported PQRI quality measures data to Medicare and will access their reports. If you are enrolled in Medicare as a sole proprietorship business, this is your only option for accessing PQRI Feedback Reports via the Internet.
 
Eligible professionals described above cannot have staff or others register to access your PQRI Feedback Reports.
 
Note: This article does not apply to (1) professionals who have reassigned all of their Medicare benefits to one or more group practices, or (2) to group practices that are limited liability companies or corporations, including those that are solely owned. Group practices that are limited liability companies or corporations, even those that are solely owned, must register in IACS as “organizations.” Registering as an organization follows a delegated authority model that begins with registration by a security official that represents the organization (the group practice) and requires submission of IRS documents. For details on registering as an IACS “organization,” see MLN Matters article SE 0831at www.cms.hhs.gov/MLNMattersArticles/downloads/SE0831.pdf (PDF, 85 KB).
 
Provider Action Needed
PQRI Feedback Reports are available on a secure website to those eligible professionals who reported PQRI quality measures in a given year. The following are the steps eligible professionals need to take to access their PQRI Feedback Reports. For access to certain CMS provider Internet applications, including PQRI Feedback Reports, you must first register in the CMS security system known as the Individuals Authorized Access to CMS Computer Services (IACS). IACS registration provides you with a User ID and password that may be used to access CMS applications such as the PQRI Feedback Reports. You only register in IACS once. As a result of that single registration, you are able to access certain other CMS Internet applications in addition to the PQRI Feedback Reports.
 
Your IACS User ID and password permit you access to confidential or sensitive Medicare information. Safeguard your IACS User ID and password once you receive them. They were assigned to you, based on information you furnished to IACS. Do not share them with others or give others permission to use them. Do not write your User ID and password on papers or documents that others may see. As a security measure, you are required to change your IACS password after you receive it, and do so every sixty days thereafter. (User IDs cannot be changed.)
 
A Five-Step Process to Access PQRI Feedback Reports
 
Step One: Determine if you should register under the “Individual Practitioner” role in IACS to access your 2007 PQRI Feedback Report.
 
Registering in IACS as an Individual Practitioner for purposes of accessing the PQRI application means that you are enrolled in Medicare with a private practice that is a sole proprietorship business, with or without employees, and you are paid directly by Medicare.
 
Step Two: Confirm your Medicare provider enrollment.
 
CMS will match your IACS registration information with the Medicare provider enrollment data before allowing you to use your IACS User ID and password to access the PQRI application. Therefore, update your Medicare enrollment information if necessary before attempting to register in IACS.  
  1. If you have not submitted a Medicare enrollment application (CMS-855) since November 2003, you will need to do so before registering in IACS. See www.cms.hhs.gov/MedicareProviderSupEnroll/ for more information about the Medicare enrollment process. To facilitate your enrollment into the Medicare program or to update your enrollment with Medicare, you should review the following downloadable file at www.cms.hhs.gov/MedicareProviderSupEnroll/downloads/Enrollmenttips.pdf (PDF, 24 KB) before submitting an enrollment application to a Medicare Administrative Contractor (MAC) or your Medicare carrier.
  2. If you submitted an enrollment application since November 2003, proceed to Step Three
  3. If you are unsure when the enrollment application was submitted, you may wish to contact your Medicare carrier or MAC  
Note: There are avoidable mistakes that can lead to an inability to match IACS data with provider enrollment data. When registering in IACS, always enter information as it was entered in your Medicare enrollment form (855). Common reasons for mismatched data:  
  • Use of first name initial instead of first name;
  • Use of nicknames, e.g. Ken vs. Kenneth
  • Use of different first names, e.g. Randal vs. David
  • Middle names included as part of the first name
  • Misspellings in names, e.g. Ray vs. Roy and Smythe vs. Smyth
  • Special characters in the last name, .e.g. dashes or apostrophes
  • Generational and/or certification/degree information in last name field and
  • Inclusion or exclusion of hyphen in name fields  
Step Three: Proceed to register as an Individual Practitioner in IACS.
 
Go to https://applications.cms.hhs.gov on the CMS Web site.
 
The IACS registration process confirms your identity by checking the data you enter against Social Security Administration records. Once your identity information is confirmed and you complete the registration process, you will receive an IACS User ID and Password, each in a separate e-mail. You will, however, be in a "pending status" until your Medicare enrollment has been confirmed.
 
In confirming Medicare enrollment, CMS will match your IACS registration information against Medicare enrollment data available after November of 2003. Confirmation occurs within one business day of receipt of your IACS User ID and password.
 
If your Medicare enrollment is confirmed you will receive a third e-mail from CMS that states: “You are currently registered in IACS as an Individual Practitioner. IACS has confirmed your Medicare enrollment. Additional provider applications may now be available to you. Pease sign into your IACS account and review the options available to you under 'Modify Profile' for more information”.
 
Note: If your Medicare enrollment is confirmed, the IACS registration process will only take 24 hours.
 
If, within one business day of receiving your IACS User ID and password, you do not get an e-mail confirming your Medicare enrollment, take the following actions:
  • If you have not submitted an enrollment application since November of 2003, update your Medicare 855 enrollment form. Follow the instructions in Step 2. In addition, if you are not receiving Medicare payments via Electronic Funds Transfer, you will also need to complete a CMS-588 “Electronic Funds Transfer (EFT) Authorization Agreement.”
  • If you have been approved to participate in Medicare since November 2003, have been billing the Medicare program, and have an active enrollment with Medicare, contact your carrier or MAC   
For additional information on registering in IACS, the Individual Practitioner New User Registration Quick Reference Guide may be found at www.cms.hhs.gov/IACS/04_Provider_Community.asp#TopOfPage.
 
Step Four: Following Receipt of Your IACS User ID and Password and a Third E-mail confirming your Medicare Enrollment, Request a PQRI User Role.
 
Once you receive the enrollment confirmation e-mail referenced in Step 3, go to the IACS site at https://applications.cms.hhs.gov.
  • Read the contents of the CMS Applications Portal Warning/Reminder screen. Enter the CMS Applications Portal by clicking the “Enter CMS Applications Portal” button at the bottom of the screen
  • On the CMS Applications Portal Introduction page, click on the “Account Management” tab at the top of the screen
  • On the Account Management page, click the “My Profile” link
  • Login using your IACS User ID and password
  • On the My Profile page, click the “Modify Account Profile” link
  • On the Modify Account Profile page under Access Request, select “Modify Provider Profile” from the Select Action list box if this is your first time requesting access to an application via IACS. If your profile is already associated to other applications that use IACS, select “Add Application” from the Select Action list box.
  • Select the “PQRI User” role  
The “Request Access to CMS Application Quick Reference Guide” provides instructions for requesting an application role. It may be found at www.cms.hhs.gov/IACS/04_Provider_Community.asp#TopOfPage.
 
Step Five: Enter PQRI Application
 
If you have reported PQRI quality measures, have an IACS account and an established PQRI User role, you may access your PQRI Feedback Report by going to http://www.qualitynet.org/pqri using your IACS User ID and password. This site also contains a user guide for the PQRI system, and instructions for interpreting your 2007 PQRI Feedback Report.
 
Additional Help for IACS
CMS has established the External User Services (EUS) Help Desk to support provider access and registration to IACS. The EUS Help Desk may be reached by e-mail at EUSSupport@cgi.com or by phone on (866) 484-8049 or TTY/TDD on (866) 523-4759. Hours of operation are Monday through Friday 7 a.m. to 7 p.m. EST.
 
Additional Help for PQRI
For help accessing the PQRI system and questions on your Feedback Report, contact the Report Delivery System Help Desk on (866) 288-8912 or via e-mail at http://qnetsupport@ifmc.sdps.org.
 
For questions concerning the status of PQRI incentive payments and any offset applied, contact your carrier or MAC provider call center. The Provider Call Center Toll Free Numbers Directory, which offers information on how to contact the appropriate provider call center, is available for download at www.cms.hhs.gov/MLNGenInfo/01_Overview.asp.
 
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 2007 American Medical Association.

 

last updated on 12/01/2008
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