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Clinical Quality Measures Report - Closing the Referral Loop: Receipt Of Specialist Report

This article covers the Clinical Quality Measure Report "Closing the Referral Loop: Receipt Of Specialist". This report is used to meet Clinical Quality Measure requirements for MIPS and Medicaid reporting programs. We'll cover the structure of the report and how it works so you can meet your Clinical Quality Measure requirements.

Overview of Measure
The Closing the Referral Loop: Receipt of Specialist Report report measures the percentage of patients with referrals, regardless of age, for whom the referring provider receives a report from the provider to whom the patient was referred.

A patient will be in the denominator when they have all of the following:

  • A visit during your reporting period 
  • A Referral SNOMED code added to their EMR or EHR from with a Start Date and End Date matching the Procedure Date of their visit.

A patient will be in the numerator when they have all of the following:

  • A Consultant Report SNOMED code added to their EMR or EHR from in the SNOMED code section with a Start Date and End Date after the Procedure Date of their visit.

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Filters

  • Filter Providers: This filter allows you to narrow the generated data to include and exclude specific providers. When checked, any selected providers will be included in the results.
  • Filter Offices: This filter allows you to narrow the generated data to include and exclude specific Office references.
  • Filter Ethnicities: This filter will allow you to narrow the generated results to specific ethnicities as designated in a patient's record under the Patients Ability > Patient Tab > Race/Ethnicity sub-tab.
  • Filter Races: This filter will allow you to narrow the generated results to specific races as designated in a patient's record under the Patients Ability > Patient Tab > Race/Ethnicity sub-tab.
  • Filter Sex: This filter will allow you to narrow the generated results to specific genders as designated by the "Sex" field in the Patients Ability > Patient Tab > Sex drop down menu.
  • Filter Insurances: This filter allows you to narrow down results to patients that have the selected insurances added in the Patients Ability > Patient Tab > Insurance Sub-Tab.
  • Filter Tax Identification Numbers: This filters narrows results based on the provider's Tax ID numbers. In this case, it will narrow down to patients with the associated providers.
  • Filter National Provider Identifiers: This filters narrows results based on the provider's National Provider Identifier (NPI). In this case, it will narrow down to patients with the associated providers.
  • Filter Provider Types: This filter will narrow results by the Provider Taxonomy codes present in References > User > Provider Tab > Provider Taxonomy. To be precise, it will narrow the results to patients associated with providers with the selected Taxonomy codes entered in the User Reference.
  • Filter Problem Lists: This filter will narrow the results down to patients who have the selected diagnosis codes entered into their Problem Lists. You can find these in the Clinical Ability under the Problem List widget.
  • Filter Practice Address: This filter will narrow results down to patients who are associated with the Office with an address that matches the selected address.
  • Start/End Date: These fields allow you to narrow the range of the generated results to the specified date range.
  • Start Age/End Age: These drop downs allow you to narrow results down to patients with ages in between the range.

Results

Unexpanded

  • Group Name: For reports with multiple numerator requirements, this identifies the numerator that is being checked for. In this report's case, there is only one numerator requirement.
  • Numerator: The number of patient that meet the numerator requirements described above.
  • Denominator: The number of patients that meet the denominator requirements described above.
  • Percentage: The percentage of patients meeting both the numerator and denominator requirements.

First expansion

  • Patient #: The Patient Account Number for the Patient in question.
  • Patient Name: The name of the patient in question, formatted as last name/first name.
  • In Numerator (Yes/No): This column identifies whether the patient in question meets the numerator requirements.
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