This is what the QCDR form looks like
What: A new form to be completed on every case – bears a passing resemblance to a Fides form and will replace that.
When: Every case to have a form completed and submitted at the same time as the record in the billing paperwork.
Why: Because full reimbursement of some of our cases depends on this being done.
How: It will come in the form packet for each case. It is self-explanatory and will take very little extra time to complete.
Required: For All Providers on all cases. Because this is so important for the company, completion rates will be tracked and will affect the annual bonus. Providers may be required to correct missing or incomplete forms.
Discussion: As part of a national policy started by the CMS (https://www.cms.gov ), reimbursement is being tied to performance- ‘merit based payment.’ (You may be aware of past efforts such as the PQRS measures for both temperature and antibiotic timing).
The new process is known overall as MACRA. (This is the Link) https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/MACRA-MIPS-and-APMs/MACRA-MIPS-and-APMs.html
The detail you need to be aware of is that we have to participate in a QCDR (qualified clinical data registry). (https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/PQRS/Downloads/2016PQRS_QCDR_MadeSimple.pdf ) Ours is constructed though our billing company, ABC, and registered with CMS.
This means an additional form separate from the rest of the chart. It does not become part of the clinical record neither is it directly part of the reimbursement submission although it is collected by the same company. It is protected Quality assurance information. It looks a bit like a Fides form. Unlike Fides there is no post-discharge section but we cover this with our separate Patient surveys. We will be phasing out the Fides program as we phase this one in.
Every provider must fill one of these out for Each case. This is not optional, it translates into $ collected on each case. For this reason provider completion rates will be tracked, the annual bonus will be affected and correction of missing or incomplete forms may be required.