Just 30 Days Left for the Submission of Informal Review of 2017 Physician Quality Reporting System Results

CMS will keenly provide a downward payment adjustment in 2017 to those who didn’t report PQRS satisfactorily in the year of 2015 including:

• Individual eligible professionals (EPs)
• Comprehensive Primary Care (CPC) practice sites
• PQRS group practices
• Accountable Care Organizations (ACOs)

Please don’t hesitate to submit an informal review request, if you’ve any queries regarding to the status of your 2015 PQRS reporting or are concerned about potentially getting the PQRS downward payment adjustment in the year of 2017. CMS will inform every individual EP or PQRS group practice that submits an appeal or request for an informal review of their 2015 PQRS information.

​Kindly submit an informal review between the time period of September 26, 2016 and November 30, 2016 requesting CMS to inquire and investigate your payment adjustment determination, if you think you’ve been wrongly assessed the 2017 PQRS payment adjustment. Within ninety days of the original and genuine request for an informal review, entire informal requestors will be notified through email of a final decision by CMS. The entire decisions will be completely final and no further review will be done then.
To submit an informal review request:, kindly follow these steps mentioned below:

1. First and foremost, go to Quality Reporting Communication Support Page (CSP) 
2. Select Communication Support Page, in the upper left-had corner of page under Related Links.
3. Then, select Informal Review Request
4. After that, select “PQRS Informal Review”
5. A new page will open
6. Enter Billing/Primary TIN (Taxpayer Identification Number), NPI (Individual Rendering National Provider Identifier), or Practice Site ID # and then finally select submit
7. In the online form, fill out the mandatory and compulsory fields, involving the suitable justification for the request to be deemed valid. Failure to fill out the form completely will result in the inability to have the informal review request observed. For extra information if important, CMS or the QualityNet Help Desk might contact the requestor.

For further information, please see PQRS informal review fact sheet.
REMEMBER: During the following Maintenance Weekends: October 21-23 and November 18-20, CSP will be unavailable.

Utilizing an Enterprise Identity Management (EIDM) account, 2015 PQRS feedback reports can be approached on the CMS Enterprise Portal . Please do see the “Quick Reference Guide for Accessing 2015 PQRS Feedback Reports” for helpful details on how to get your report. Please see the “2015 PQRS Feedback Report User Guide”, for further information on understanding your report. Both guides are present on the PQRS Analysis and Payment webpage.

Kindly contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or Qnetsupport@hcqis.org on the days of Monday-Friday from 7:00 a.m. to 7:00 p.m. Central Time, for any extra queries regarding to the informal review procedure. Don’t involve any personal identifying information to avoid any sort of security violations, like Social Security Number or TIN, in e-mail inquiries to the QualityNet Help Desk.