The first filter under Form Filters is for patient search. You can search for a patient by :
HICN - Health Insurance Claim Number
MBI - Medicare Beneficiary Identifier
Last Name - Patient Last Name
First Name - Patient First Name
MRN - Medical Record Number
DOB - Patient Date of Birth
For DOB you must use the exact date. All other searches you can choose:
Starts With - Based on patient data that begins with the text entered
Exact Match - Based on an Exact Match to patient data entered
Ends With - Based on patient data that ends with the text entered.
The next search filter is for TIN and Facility. You have the options to search by:
TIN - Taxpayer Identification Number of practice patients belong to.
Facility Name - Name of Associated Care Facility
Facility Number Facility Number of Associated Care Facility
Facility Division - Choose from list of divisions for your organization (if applicable)
Sub-TIN - Choose from Sub-Tin of practice to which they belong
NPI - National Provider Identification Number of provider patient belong to
Provider Name - Name of provider patient belongs to
As above users may search by Starts with, Exact Match and Ends with.
Patient claims Filters - Allows users to search patient claims data relevant to the quality measure responses. Multiple measures may be selected in this filter, and patients with claims data in at least one of the selected measures will be included in the search results.
Module and Module Status - These filters will narrow the patient list search results based on patients with response data matching the choices in the 'Module Status' section for the quality measures chosen in the "Module' section.
Complete (C) - Quality measure is complete with a performance response.
Complete with Non-Performance Answer (CNP) - Quality measure is complete with a non-performance response
Exception (Medical, Patient, System Reason) (E) - Quality measure is exempt due to specific response circumstances
Skipped (S) - Patient does not qualify for this measure based on measure-specific restrictions such as age or gender.
Incomplete (I) - Patient response to this quality measure has not been submitted
Module Rank - Choose a rank or rank range to view patients that meet the criteria selected.
Patient Responses - Allows users to select one measure and potential responses to that measure. Results will show patients that meet the specified criteria.
Patient Quality Score - Filter shows patients with an overall quality measure score between the two percentages entered. This can be useful to help prioritize patients with lower scores.
Patient Progress Score - Filter shows patients whose completed measures fall between two entered values. Like the Quality Score, this can be useful for finding patients with few or no quality measures completed.
Patient Questionnaire Status- Search filter shows patients whose overall questionnaire has one of the four primary Status. More than one status can be selected, and will display patients with one of the selected statuses.
Green - Questionnaire Completed
Blue - Questionnaire In Progress
Red - Questionnaire Not Started
Yellow - Questionnaire Skipped
Data Source Filter - Shows patients with measures that have been filled out through one of several different methods.
EMR Import - Measures answered by an EMR file, a large import file that is imported via a specialized back-end process
Claims Import - One or more measures answered by a CCLF claim file from CMS. Eligible measures are automatically answered in this way based on claims data for the patient.
Manually Keyed - One or more measures answered manually by a user within the system.
Single/Spec File - Searches for patients with one or more measures answered using either Single or Spec File spreadsheet uploads in the system.
Not Done/No Dx - Patients with one or more measures filled in as either non-performance or no diagnosis. This is often due to an absence of response, and is usually replaced by a true answer or data at a later time.
N/A Age/Gender - Patients who were skipped in one or more measures based on age or gender disqualifications
Carried Over - Patients with one or more measures filled in with an answer from a previous year.
EMR Import and Single/Spec File imports - These imports have additional parameters available. Once you select one of the options you will see and option to choose the Import date From /To fields to narrow your search down to a smaller list of files. The Import files lists all files that were placed into the system during that date range and allows you to select one. If you do not enter a date range you will see the full list of files.
Deceased / Living Status Options - Search filter will show patients that are in the system as either alive or deceased. By default, both are selected.
Medical Record Status - Filter allows you to filter results based on the availability of medical records for patients, or allows for filtering of just patients who are not qualified for sampling.
Once you have the desired search filters selected, click the button to generate results in the patient list. Alternatively, click the to remove all selected filters and start the search form anew.
Chart Filters are located directly below the Form Filters. To access the chart Filters click on the green plus sign. These filters will show your company's current progress based on a ratio of responses for each measure. The bars in each row when added together, total 100% for each of the quality measures. Hover over a section of the bar and a pop-up will show the measure, type of response being measured, and the current number of patients in that response type. If you click on a section of the bar the patient grid will filter to those patients in the patient grid below. This will also adjust the filter options in the form filters above. This chart is updated in real time, so as you manually enter answers or files are uploaded you will see the charts update accordingly.
Yellow Bar - Indicates patients Not Qualified for the measure.
Orange Bar - Indicates patients Skipped / Non-Applicable (N/A) for the measure
Blue Bar - Indicates patients with a Performance Answer for the measure
Lavender Bar - Indicates Patients with an Exception/Exclusion for the measure
Red Bar - Indicates Patients with a Non-Performance Answer for the measure
Gray Bar - Indicates Patients that are currently incomplete.
Patient List - Can be found directly below the form and chart filters. Be default all accessible patients are displayed. As filters are used, the list will become more specialized. The first half of the patient list shows all basic patient information. This includes patient's HICN, MBI, MRN, First and Last Name, Date of Birth and living Status, current Quality Score Percentage, current Progress Score. The next section covers Division, Facility Name, Sub-TIN, Facility Number, Provider Name, and NPI_1, NPI_2 and NPI_3 to which the patient is assigned.
At the top of the patient list window, there are two buttons, . Clicking on Excel Export will send a request for a QM Questionnaire Report. This report is not generated immediately, but instead appears just below the Chart Filters section after the request has been completed. Please note this can take several minutes for the report to generate. Clicking Clear Search Criteria will remove any search filters and show all available patient data.
The far left Action column of the patient list contains links to two other sections. The right icon which is either a blue circle or a blue notepad, ( , ) leads to the patient chart and claims data window. The left icon, a colored flag, ( ) leads to the quality measures questionnaire page.
The patient list also contains a summary of current quality measure data on the right half of the table. If a patient has been selected as part of the random sample you will see their rank in the applicable measure. You can sort each column to view ranked patients in order.
WHITE Number - Ranked and Incomplete module
RED Number - Ranked and Complete module with non-performance answer
GREEN Number - Ranked and Complete module with performance answer
BLUE Number - Ranked and Complete module with denominator exception answer (non scored)
ORANGE Number - Ranked Patient and Skipped (e.g. N/A chosen). Only module is skipped, not the entire patient
- Patient has claims data. Clicking in the box with this icon will bring up a window with the ability to click on 'Claims' and view applicable claims.
Clicking on the ranked number will open a window containing that measure. If the answer is already filled in the information will be available for viewing. If you wish to manually key the information for the measure, you may fill in a response or update a response and click .
To access the Patient Quality Measure Questionnaire, click on the colored flag ( ) to the far left of the patient grid in the 'Action' column.
The top of the questionnaire page shows the patient's basic information, Medical Record Status, Measures patient is ranked for and patient's quality progress.
If the patient is 'Not Qualified for Sample', a reason must be selected and the date the patient become not qualified must be entered.
For each quality measure that the patient is ranked for will be outlined below the patient information. Patient rank for the measure will be shown in the green bar at the top of the measure section. If data already exists, then the date and form of the data submission is shown in red font. In addition, the option to manually key the data is available, whether prior data for the measure exists or not. For every measure there is a response highlighted in Purple. This is considered a non-performance response.
Some measures may contain associated claims data, also known as 'CCLF Data'. A summary of each claim will be listed within the measure itself. Click on the Red claims bar and the bar will open with additional information.
You may also view claims by clicking on the Blue Paper icon in the 'Action' column and clicking on the 'Patient Lookup' tab.
Some measures may also contain historical data if the patient's response data has been saved more than once. Under the 'History' tab you may find previous service dates and comments for specific quality measures. Click on the to open and view historical data.