CMS50v12 – Closing the Referral Loop: Receipt of Specialist Report

Closing the Referral Loop: Receipt of Specialist Report CMS50v12 Percentage of patients with referrals, regardless of age, for which the referring clinician receives a report from the clinician to whom the patient was referred.
– DENOMINATOR

Number of patients, regardless of age, who had an encounter during the measurement period and were referred by one clinician to another clinician on or before October 31.

A qualifying encounter in this case can include any of the following:

  • Office Visit
  • Ophthalmological Visit
  • Preventive Care Services Established Office Visit, 18 and Up
  • Preventive Care Services Initial Office Visit, 0 to 17
  • Preventive Care Services Initial Office Visit, 18 and Up
  • Preventive Care, Established Office Visit, 0 to 17

– NUMERATOR

Number of patients with a referral on or before October 31, for which the referring clinician received a report from the clinician to whom the patient was referred.

Note: The consultant report should contain the outgoing referral ID and must be received on a date after the referring clinician sent the referral and during the measurement period.

– APPLICATION WORKFLOW

For Denominator:

  • To document a Referral, navigate to Patient > Provider Note > Referrals. Create a referral and then click ‘Save & Accept’.
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Documenting a Referral
  • To record a visit, navigate to Patient > Provider Note > Create Superbill. Under the ‘Procedures-CPT’ heading, enter the relevant encounter code.
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eSuperbill for Encounter

For Numerator:

To view a report, navigate to Patient > Registration > Incoming Referrals > Attachments. Click on the attachment to view it.

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Attachment with Referral