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Residency Clinic and MU/CQM Qualifiers

MU, CQR, PQRS, etc.

Last Post by Anonymous 1 second ago

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srock

(@srock)

Posts: 81

Estimable Member

Topic starter

Is there anyone who can help me understand the functionality of MU and CQMs in relation to residents and preceptors?

Our workflow is: create new document with the resident listed as the responsible provider. The resident does all of the work and signs the document. The document is then co-signed by the preceptor.

Questions related to our workflow:
(1) Will those patients be counted in the denominator for both the resident and the preceptor?
(2) If #1 is yes, is it ok to report on the same patient/same encounter for both the resident and preceptor?

Thank you so much for your time.

Posted : September 22, 2015 5:01 am

bruins1986

(@bruins1986)

Posts: 233

Reputable Member

1 - Yes. From our continued testing anyone who signs the encounter gets credit for it so it double counts for multiple users in many cases (NPs and supervisors, PCPs "acknowledging" specialist notes, your case). This is automatic for functional measures as the CQR only uses the "seen by" logic for said measures. For the CQMs the encounter would also need either a (counted) CPT service order or that special SNOMED workaround.

I thought GE said they modified their "Seen by" criteria but we are currently testing the CQM SNOMED workaround and are finding credit is still given to anyone that signs the encounter the order was placed in. Another specialist was told this was still the case on a roundtable yesterday (I believe it was).

2. I'm still trying to figure this out as well and would love if someone knew the answer definitively. In my humble opinion I would think the answer is that this is not OK but we've been put between a rock and a hard place by GE.

Thanks

Mike

Posted : September 23, 2015 3:09 am

dgoldsmith

(@dgoldsmith)

Posts: 38

Trusted Member

This may be useful to you:
I recently had this exchange with a GE consultant regarding co-signing documents and credit for MU:

[ME] This statement is in the most recent MU guide: “Updated Functional Measures Document Type: Added this Note: "Documents co-signed at least one day after the original signature will not be associated with the EP unless they are appended."”
What does this statement mean?
[GE] If a document is [already] signed, but then the EP [preceptor] does not sign that document within a day – it will not get associated with the EP. Essentially, any co-signatures need to happen within a day or the documents will not get included in the calculations for that provider. However, if the document is being appended – it does get included in the calculations.
[ME] Is the purpose of this to eliminate unnecessary associations if another provider co-signs?
[GE] I do believe that this is an issue – and an SPR has been created for it. It really has to do with the JSON file being generated at the end of the day and exported, and the additional signature does not re-generate a JSON file.

I was told that we had the option to either include all or exclude all of the resident visits for our EPs. We made the decision to exclude all...so, our EPs do a completely separate preceptor note (no append and no co-sign).
If you want to ensure the resident visits are associated with an EP, then I would go with the append route to ensure they get credit.

I have seen that if two EPs sign the same note or create an append to the note, they will each get credit for that pt. Whether or not that is allowable...is unknown to me. I was assuming this was ok if GE is calculating things this way...
I have not tested the credit given or not if signed a day later.

Are your residents designated as EPs?

Posted : September 24, 2015 6:59 am

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