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Only 7 Days Left to Submit an Informal Review Request for 2017

11/24/2016

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 A downward payment adjustment in 2017 will be applied by CMS to those who didn’t satisfactorily report PQRS in 2015 involving:
  • Comprehensive Primary Care (CPC) practice sites
  • Individual eligible professionals (EPs)
  • Accountable Care Organization (ACO) participant TINs
  • PQRS group practices
Please don’t hesitate to submit an informal review request, if you’ve any queries in context to the status of your 2015 PQRS reporting or are concerned over potentially getting the PQRS downward payment adjustment in 2017. Every individual EP or PQRS group practice will be in contact and in-touch with the CMS that submits an informal review request of their 2015 PQRS data.
Please submit an informal review between September 26, 2016 and November 30, 2016 requesting CMS investigate your payment adjustment determination, if you consider you’ve been wrongly or incorrectly assessed the 2017 PQRS payment adjustment. Entire informal review requestors will be notified through email of a final decision by CMS within ninety days of the original and genuine request for an informal review. There will be no further review and all decisions will be final.
To submit an informal review request, follow these steps:
  1. Go to the Quality Reporting Communication Support Page (CSP) 
  2. In the upper left-hand corner of the page, under “Related Links,” select “Communication Support Page”
  3. Choose “Informal Review Request”
  4. Select “PQRS Informal Review”
  5. A new page will open
  6. Enter Billing/Primary Taxpayer Identification Number (TIN), Individual Rendering National Provider Identifier (NPI), OR Practice Site ID # and select “submit”
Do complete all the compulsory and mandatory fields in the online form, involving the suitable and appropriate justification for the request to be deemed valid. Failure or unable to complete the form in full will result and outcome in the inability to have the informal review request analyzed. For further information if important, CMS or the QualityNet Help Desk might contact the requestor.
For more information, please visit the PQRS informal review fact sheet.
​

Point To Remember: Any EP or group that is awaiting a response or resolution of a QualityNet Help Desk ticket to access their PQRS Feedback Report or QRUR might still submit an informal review after the day of November 30, 2016, by giving verification of a QualityNet Help Desk ticket numbers generated before the end of the informal review period (November 30, 2016) that include EIDM access. Individuals or groups as identified by their TIN (taxpayer Identification Number) might also use EIDM-related help desk tickets generated during the informal review time period to enable late filing of a Value Modifier or PQRS informal review request. Through December 7, 2016, these late request might be submitted.
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  • Home
  • Features
    • Why Choose Us?
    • Consulting
    • Security
    • About
  • Services
    • Provider Credentialing
    • Medical Billing Services
    • Denial Management
  • Request a Quote
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  • Contact
  • WIKI
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  • Login