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1. Dysfunction LVEF lt 40 CMS182 Ischemic Percentage of patients 18 years of age and Clinical Vascular older who were discharged alive for acute Process Disease IVD myocardial infarction AMI coronary artery Effective Complete Lipid bypass graft CABG or percutaneous ness Panel and LDL coronary interventions PCI in the 12 Control months prior to the measurement period or who had an active diagnosis of ischemic vascular disease IVD during the measurement period and who had a complete lipid profile performed during the measurement period and whose LDL C was adequately controlled lt 100mg dL CMS135 Heart Failure Percentage of patients 18 years of age and Clinical HF older with a diagnosis of heart failure HF Process Angiotensin with a current or prior left ventricular ejection Effective Converting fraction LVEF lt 40 who were prescribed ness Enzyme ACE ACE inhibitor or ARB therapy either within a Inhibitor or 12 month period when seen in the outpatient Angiotensin setting OR at each hospital discharge Receptor Blocker ARB Therapy for Left Ventricular Systolic Dysfunction LVSD CMS144 Heart Failure Percentage of patients 18 years of age and Clinical HF Beta older with a diagnosis of heart failure HF Process Blocker with a current or prior left ventricular ejection Effective Therapy for fraction LVEF lt 40 who were prescribed ness Lef
2. otherwise Calendar Year Calendar year Stage 1 MU if SLR Group Administrator User Guide 37 Stage 1 MU Year 3 is 2013 otherwise Stage 2 Year 4 90 days if Year 4 is 2014 90 days if Year 4 is 2014 otherwise Calendar year otherwise Calendar year MU MU Stage 2 Stage 2 Year 5 Calendar year MU Stage Calendar year MU Stage 3 2 planned Year 6 Calendar year MU Stage Calendar year MU Stage 3 3 planned planned The system itself will only allow choices to the providers that are appropriate for the year and their stage in the process Start Date and End Date fields have an icon EF that will open a Calendar Utility that allows a user to select a date rather than enter it into the field 90 Day Reporting Period Start Date Esl End Date E 4 Meaningful Use Import This page allows providers to import Core and Menu objective data Data imported in this manner will display on the individual Core and Menu Objective detail pages as read only data All validations performed on individual Core and Menu pages will be enforced and the appropriate visual indicators will be displayed in the navigation tree Click the MU Import Control Document link to open technical specifications for the import file Note the import function will import all records in the file or none of the records if an error occurs with the import If all required data is not populated f
3. Clinical up Care for newly dispensed a medication for attention Process Children deficit hyperactivity disorder ADHD who Effective Prescribed had appropriate follow up care Two rates ness Attention are reported Deficit Hyperac a Percentage of children who had one tivity Disorder follow up visit with a practitioner with ADHD prescribing authority during the 30 Day Medication Initiation Phase SLR Group Administrator User Guide 44 b Percentage of children who remained on ADHD medication for at least 210 days and who in addition to the visit in the Initiation Phase had at least two additional follow up visits with a practitioner within 270 days 9 months after the Initiation Phase ended CMS2 Preventive Percentage of patients aged 12 years and Population Care and older screened for clinical depression on the Public Screening date of the encounter using an age Health Screening for appropriate standardized depression Clinical screening tool AND if positive a follow up Depression plan is documented on the date of the and Follow Up positive screen Plan CMS75 Appropriate Percentage of children 3 months 18 years Efficient Treatment for of age who were diagnosed with upper Use of Children with respiratory infection URI and were not Healthcare Upper dispensed an antibiotic prescription on or Resources Respiratory three days after the episode Infection
4. influenza type B HiB three hepatitis B Hep B one chick pox VZV four pneumococcal conjugate PCV one hepatitis A Hep A two or three rotavirus RV and two influenza flu vaccines by their second birthday CMS147 Preventive Percentage of patients aged 6 months and Population Care and older seen for a visit between October 1 and Public Screening March 31 who received an influenza Health Influenza immunization OR who reported previous Immunization receipt of an influenza immunization CMS2 Preventive Percentage of patients aged 12 years and Population Care and older screened for clinical depression on the Public Screening date of the encounter using an age Health Screening for appropriate standardized depression Clinical screening tool AND if positive a follow up Depression plan is documented on the date of the and Follow Up positive screen Plan CMS69 Preventive Percentage of patients aged 18 years and Population Care and older with a documented BMI during the Public Screening encounter or during the previous six months Health Body Mass AND when the BMI is outside of normal Index BMI parameters follow up plan is documented Screening and during the encounter or during the previous Follow Up six months of the encounter Normal Parameters Age 65 years and older BMI gt 23 and lt 30 Age 18 64 years BMI gt 18 5 and lt 25 CMS82 Maternal The percentage
5. Answer to the Challenge Question Phone 4i i E mail address email email com name domain com Cancel and lose My Account changes SLR Group Administrator User Guide Navigating SLR Hard and Soft Stops Certain fields are required to be populated like the Professional License Number field on the Step 1 About You page Other fields are both required to be populated and checked against another system to ensure they are correct such as the EHR Certification Number field on the EHR Certification page The State decides whether required fields are hard or soft stops e Hard Stop the system will not allow the user to proceed to the next step without populating the field and having it validated correctly if necessary The information on the page cannot be saved until the field is populated correctly e Soft Stop the user may proceed and enter other information in the system though the field is still required and must be completed before the user can proceed to Step 4 Awarning message will be displayed on the page and an icon will be visible in the Navigation Menu At Step 4 the Attestation Agreement is produced and at this point all required fields must be completed before it can be generated Save and Continue SLR pages that require data entry have a Save amp Continue button _Save amp Continue When this is selected measures entered onto certain pages are validated For example the Total Medicaid
6. Clicking this link opens a pop up window with the Provider SLR Application Information report results This report prints all of the Attestation information that you have already entered The Registration and Attestation Summary report displays the following a g h Identifying Information section displays the information you entered when you created your SLR account Filing Information displays the Program Year and status of the Attestation association About You section displays the information saved when you completed the About You section Confirmation of Eligibility section displays the information saved when you completed the Confirm Medicaid Eligibility section Summary of Meaningful Use Core Measures displays Core Objective measures if these were entered Summary of Meaningful Use Menu Measures Summary of Core Clinical Quality Measures Summary of Alternate Core Clinical Quality Measures Summary of Additional Clinical Quality Measures You can print this report after you have saved any of your information in the SLR Web application If you print the report before all of the areas have been completed only those sections with saved information will print on the report You can also filter the report by year SLR Group Administrator User Guide 61 Viewing Payment Status Payment Calculations Payment Information and Calculations for Eligible Professionals Payment Information section located on the lef
7. URI CMS129 Prostate Percentage of patients regardless of age Efficient Cancer with a diagnosis of prostate cancer at low Use of Avoidance of risk of recurrence receiving interstitial Healthcare Overuse of prostate brachytherapy OR external beam Resources Bone Scan for radiotherapy to the prostate OR radical Staging Low prostatectomy OR cryotherapy who did not Risk Prostate have a bone scan performed at any time Cancer since diagnosis of prostate cancer Patients Clinical Process Effectiveness CMS137 Initiation and Percentage of patients 13 years of age and Clinical Engagement of older with a new episode of alcohol and other Process Alcohol and drug AOD dependence who received the Effective Other Drug following Two rates are reported ness Dependence a Percentage of patients who initiated Treatment treatment within 14 days of the diagnosis b Percentage of patients who initiated treatment and who had two or more additional services with an AOD diagnosis within 30 days of the initiation visit CMS125 Breast Cancer Percentage of women 40 69 years of age Clinical Screening who had a mammogram to screen for breast Process cancer Effective ness CMS124 Cervical Percentage of women 21 64 years of age Clinical Cancer who received one or more Pap tests to Process Screening screen for cervical cancer Effective ness CMS130 Colorectal Percentage of adults 50 75 years of age who Clinical Cancer had appropriate scree
8. applied consistently to all denominators for the measures That is eligible hospitals and CAHs must choose either the Observation Services method or the All ED Visits method to be used with all measures Providers cannot calculate the denominator of some measures using the Observation Services method while using the All ED Visits method for the denominator of other measures Before attesting eligible hospitals and CAHs will have to indicate which method they used in the calculation of denominators All ED Visits Method An alternate method for computing admissions to the ED is to include all ED visits POS 23 only in the denominator for all measures requiring inclusion of ED admissions All actions taken in the inpatient or emergency departments POS 21 and 23 of the hospital would count for purposes of determining meaningful use Allergy An exaggerated immune response or reaction to substances that are generally not harmful Unique Patient If a patient is seen by a provider more than once during the EHR reporting period then for purposes of measurement that patient is only counted once in the denominator for the measure All the measures relying on the term unique patient relate to what is contained in the patient s medical record Not all of this information will need to be updated or even be needed by the provider at every patient encounter This is especially true for patients whose encounter frequenc
9. as PHQ 9 score less ness than 5 This measure applies to both patients with newly diagnosed and existing depression whose current PHQ 9 score indicates a need for treatment CMS160 Depression Adult patients age 18 and older with the Clinical Utilization of diagnosis of major depression or dysthemia Process the PHQ 9 who have a PHQ 9 tool administered at least Effective Tool once during a 4 month period in which there ness was a qualifying visit CMS75 Children who Percentage of children ages 0 20 years who Clinical have dental have had tooth decay or cavities during the Process decay or measurement period Effective cavities ness CMS74 Primary Caries Percentage of children ages 0 20 years Clinical Prevention who received a fluoride varnish application Process SLR Group Administrator User Guide 49 Intervention as during the measurement period Effective ALL prescriptions over the counters herbals and vitamin mineral dietary nutritional supplements AND must contain the mediations name dosage frequency Offered by ness Primary Care Providers including Dentists CMS61 Preventive Percentage of patients aged 20 through 79 Clinical Care and years whose risk factors have been Process Screening assessed and a fasting LDL C test has been Effective Cholesterol performed ness Fasting Low Density Lipoprotein LDL C Test Performed CMS64 Preven
10. between ness each visit CMS52_ HIV AIDS Percentage of patients aged 6 weeks and Clinical Pneumocystis older with a diagnosis of HIV AIDS who were Process jiroveci prescribed Pneumocystis jiroveci pneumonia Effective pneumonia PCP prophylaxis ness PCP Prophylaxis CMS77_ HIV AIDS Percentage of patients aged 13 years and Clinical RNA control for older with a diagnosis of HIV AIDS with at Process Patients with least two visits during the measurement year Effective HIV with at least 90 days between each visit ness whose most recent HIV RNA level is lt 200 copies mL CMS133 Cataracts Percentage of patients aged 18 years and Clinical 20 40 or Better older with a diagnosis of uncomplicated Process Visual Acuity cataract who had cataract surgery and no Effective within 90 Days significant ocular conditions impacting the ness Following visual outcome of surgery and had best Cataract corrected visual acuity of 20 40 or better Surgery distance or near achieved within 90 days following the cataract surgery CMS158 Pregnant This measure identifies pregnant women Clinical women that who had a HBsAg hepatitis B test during Process had HBsAg their pregnancy Effective testing ness CMS159 Depression Adult patients age 18 and older with major Clinical Remission at depression or dysthymia and an initial PHQ 9 Process Twelve Months score gt 9 who demonstrate remission at Effective twelve months defined
11. function Select the subject for the first attachment from the drop down list Use the Select function to choose your file Click the Add button to add another file Select the s ct for the second attachment from the drop down list Use the Select function to choos fil When all documents are attached click the Attach button Allowed File Types bmp pdf jpeg jpg gif png doc docx xis xIsx Subject FPN File s Subject Filename oy Attach x Cancel and lose file changes Timing Out SLR pages have a session timeout occur at 9 minutes and 30 seconds If no field has been modified or a page accessed during that time a pop up window shall appear asking if you wish to log out or continue to use SLR The pop up window itself will disappear in 30 seconds if no action is taken SLR Group Administrator User Guide 64 Troubleshooting Accessing Help For general Help all SLR web pages have a Help Link that opens up a copy of this User Manual For SLR Web application assistance you can contact the ACS Help Desk designated to support the SLR Phone 866 879 0109 Email SLRHelpdesk acs inc com Help Text Displays Located throughout the SLR Web application there are tool tips help text and more info links that should help to complete the pages 1 Tool Tips A tool tip is text that displays when you hover your mouse over an area on the page CMS Medicaid EHR Incentive Program Regist
12. is available here http Awww htsrec com Important Web Resources ail links open in n CMS EHR Incentive Program Registration site Centers for Medicare amp Medicaid Services CMS rtifi IT Provider Outreach Home Contact Us Medicare and Medicaid EHR Incentive Programs p Bun the CMS Etabity Wizard and quickly see if you may qualify for incentive payments R Se Have a question Click here to view the CMS listof frequently asked questions Healthcare IT News all links open in new window Oct 22 2012 Power to the Patient Oct 19 2012 Oct 18 2012 To get to the login page from the Provider Outreach page click on the go directly to the State Level Registry for Provider Incentive Payments located on the upper left hand corner of the Provider Outreach webpage SLR Group Administrator User Guide 10 Need to create an SLR account Click here to leave this site and create an SLR account for accessing the Montana Medicaid EHR incentive Program site SLR login directly from the SLR login URL If you have already created an account you can also get to the SLR s Login page by entering the URL into your browser httos mt arraincentive com Type the Montana State Level Registry URL in the address field and press the Enter key on your keyboard From here you will reach the SLR Web application Login page You ll have three chances to enter in the co
13. of children who turned 6 Population Depression months of age during the measurement year Public Screening who had a face to face visit between the Health clinician and the child during child s first 6 months and who had a maternal depression screening for the mother at least once between 0 and 6 months of life CMS22 Preventive Percentage of patients aged 18 years and Population Care and older seen during the reporting period who Public Screening were screened for high blood pressure AND Health Screening for a recommended follow up plan is High Blood documented based on the current blood Pressure and pressure BP reading as indicated Follow Up Documented Patient and Family Engagement Domain CMS157 Oncology Percentage of patient visits regardless of Patient Medical and patient age with a diagnosis of cancer and Radiation currently receiving chemotherapy or radiation Family Pain Intensity therapy in which pain intensity is quantified Engageme Quantified nt CMS66 Functional Percentage of patients aged 18 years and Patient status older with primary total knee arthroplasty and assessment for TKA who completed baseline and follow up Family knee patient reported functional status Engageme replacement assessments nt 52 SLR Group Administrator User Guide CMS56 Functional Percentage of patients aged 18 years and Patient status older with primary total hip arthroplasty and assess
14. of low back pain who did not Use of Back Pain have an imaging study plain X ray MRI CT Healthcare scan within 28 days of the diagnosis Resources CMS153 Chlamydia Percentage of women 16 24 years of age Population Screening for who were identified as sexually active and Public Women who had at least one test for Chlamydia Health during the measurement period CMS126 Use of Percentage of patients 5 64 years of age Clinical Appropriate who were identified as having persistent Process Medications for asthma and were appropriately prescribed Effective Asthma medication during the measurement period ness CMS117 Childhood Percentage of children 2 years of age who Population Immunization had four diphtheria tetanus and acellular Public Status pertussis DTaP three polio IPV one Health measles mumps and rubella MMR three H influenza type B HiB three hepatitis B Hep B one chicken pox VZV four pneumococcal conjugate PCV one hepatitis A Hep A two or three rotavirus RV and two influenza flu vaccines by their second birthday CMS154 Appropriate Percentage of children 3 months 18 years of Efficient Treatment for age who were diagnosed with upper Use of Children with respiratory infection URI and were not Healthcare Upper dispensed an antibiotic prescription on or Resources Respiratory three days after the episode Infection URI CMS136 ADHD Follow Percentage of children 6 12 years of age and
15. representing that Step in the SLR process and each will have a completion icon that shows the status of the step The user is able to move unto the next step only after completing the first 1 About Your Group section allows you to enter information about the Group s primary contact By default this is populated with your user information 2 Confirm Group Eligibility section allows you to enter patient and Medicaid volume information 3 Group Certified EHR Information section allows you to enter Certified EHR technology information in particular the EHR Certification Number of your Group s software Each member of the Group will still have to attest to the technology they are using but the information may be pre populated for them 4 Manage Providers in Your Group section allows you to add members to your Group Enter Data on Behalf of Your Providers section page provides access to the individual pages of each provider in your Group In this way you can add or edit the information for each of these providers Workflow Section Details This section describes in more detail the specific steps needed to set up a Group in the SLR system Starting with Step 1 the About Your Group page you will enter your registration and contact information Like Eligible Professional users Group Users will have a Navigation SLR Group Administrator User Guide 55 Menu to both access pages and keep track of their progress The five options co
16. unique patient population If the EP s CEHRT does not contain patient data for at least 9 CQMs covering at least 3 domains then the EP must report the CQMs for which there is patient data and report the remaining required CQMs as zero denominators as displayed by the EP s CEHRT CMS has recommended core sets of clinical quality measures that focus on high priority clinical conditions for Eligible Professionals for both Adult and Pediatric measures To select one of the recommended core measure sets please select the appropriate option below To select measures individually check the Select check box for the measure If you select measures individually you must ensure you select 9 measures that cover 3 National Quality Strategy domains I wish to report on the Adult Recommended Core Measures O I wish to report on the Pediatric Recommended Core Measures I wish to select 9 Measures from the list Import Clinical Quali Efficient Use of Healthcare Resources Domain Measure Data CMS eMeasure ID Title Description CMS146 CMS166 CMS154 Appropriate Testing for Children with Pharyngitis Use of Imaging Studies for Low Back Pain Appropriate Treatment for Children with Upper Respiratory Infection URI Percentage of children 2 18 years of age who were diagnosed with pharyngitis ordered an antibiotic and received a group A streptococcus strep test for the episode Percentage of patients 18 50 years of ag
17. will enter data that has been captured by their EHR Software A report within your EHR system should be available to help you enter the correct information in the MU fields In the provider s second participation year clicking the 3 Attestation of EHR link will open the EHR Certification page directly as the user has the option to adopt implement or upgrade their software only in the first year of participation Providers may elect to enter Meaningful Use data during their first year of Attestation but must enter MU information during each year after their first year The first year of MU is called Stage 1 and fields are grouped into a series of Objectives and Clinical Quality Measures Stage 2 of the Meaningful Use program begins in 2014 and this will require more fields to be populated and data to be captured When providers attest for MU they will enter the data captured by their software for a specified time period either 90 days or a full year of data The year 2014 has more changes in Meaningful Use measures as Stage 1 question are modified slightly Providers need to upgrade to 2014 Edition EHR technology regardless of the Meaningful Use stage they need to meet A third and final stage of Meaningful Use is scheduled to begin in 2016 Note Meaningful Use measures are based solely on encounters that occurred at locations where the certified EHR solution is available In order to qualify for the EHR Incentive payment 80 of patie
18. 134 Diabetes Urine Percentage of patients 18 75 years of age Clinical Protein with diabetes who had had a nephropathy Process Screening screening test or evidence of nephropathy Effective during the measurement period ness CMS163 Diabetes Low Percentage of patients 18 75 years of age Clinical Density with diabetes whose LDL C was adequately Process Lipoprotein controlled lt 100 mg dL during the Effective LDL measurement period ness Management CMS164 Ischemic Percentage of patients 18 years of age and Clinical Vascular older who were discharged alive for acute Process Disease IVD myocardial infarction AMI coronary artery Effective Use of Aspirin bypass graft CABG or percutaneous ness or Another coronary interventions PCI in the 12 Antithrombotic months prior to the measurement period or who had an active diagnosis of ischemic vascular disease IVD during the measurement period and who had documentation of use of aspirin or another antithrombotic during the measurement period CMS145 Coronary Percentage of patients aged 18 years and Clinical Artery Disease older with a diagnosis of coronary artery Process CAD Beta disease seen within a 12 month period who Effective Blocker also have a prior MI or a current or prior ness Therapy Prior LVEF lt 40 who were prescribed beta Myocardial blocker therapy Infarction MI or Left Ventricular Systolic 46 SLR Group Administrator User Guide
19. About You Y 2 Confirm Medicaid Eligibility 3 Attestation of EHR Icon Legend Y Complete A Warning Hard Stop In the example above the provider has completed Steps 1 and 2 and is now at Step 3 A required field has not been completed A hard stop will prevent the page from being saved SLR Group Administrator User Guide 21 Applying for the Incentive as an Eligible Professional EP After you log in as an Eligible Professional EP user and accept the EULA the EP home page will open The home page serves as a dashboard and navigation tool for the SLR application Home Page The SLR Home page for EPs displays the following 1 Banner section Located at the top of the page the banner displays the following items that are visible on every page of the SLR application a b Montana s Medicaid logo and tagline SLR heading Montana Medicaid State Level Registry for Provider Incentive Payments This is the name of the application My Account link opens the My Account page Help link displays a PDF copy of this User Manual Contact Us link a pop up page displaying contact information including the ACS Help Desk phone number and email address Logout link allows you to log out of the SLR Web application Filing as Eligible Professional message designates your Provider Type Practice Name display field the name of your practice Practice Street Address display field your practice s street addre
20. Encounters entry must be 30 of the Total Encounters entry on the Confirm Eligibility page Only the Save amp Continue button will validate that the information in required fields is correct and save the results to the database Using any other kind of navigation the Back button on your browser or links in the Navigation Menu for example will abandon the page and the entries will not be saved Navigation Bar In Version 2 of SLR moving through the site is assisted by the use of a Navigation Menu on the left hand side of SLR pages though it does not appear on the Home page Only links to pages that are available to be accessed will be active in the Navigation Menu Inactive links appear light gray in color while active links are blue Icons appear next to the page links that indicate the status of each page and section in SLR whether it is complete has generated an error notice Ay or a required field or task was left undone Click the expend icon to 4 view all the submenu items Click the collapse icon El to hide the submenu items If the user elects to attest to the Meaningful Use MU of their EHR Technology solution MU Objective and CQM Clinical Quality Measure links will appear in the Navigation Menu lf the user attests to the Adoption Implementation or Upgrade AIU of the EHR Technology solution the AIU Method and EHR Certification page links will appear SLR Group Administrator User Guide 20 1
21. Enter the letters numbers from the image above Continue Cancel ang return to Login Clicking the Continue button opens the next page where you will confirm that the information the system has retrieved up is accurate The Create Account Confirmation page displays the following 1 NPI display field the NPI you entered on the Identify Yourself page 2 TIN display field the TIN entered on the Identify Yourself page 3 Medicaid ID display field the Medicaid ID associated with the NPI and TIN you entered 4 Name display field the name associated with the NPI and TIN you entered Address display field the address associated with the NPI and TIN you entered 6 Active display field will display true if the NPI TIN is active with the state Medicaid program and false if it is inactive 7 No Go back button returns to the previous page 8 Yes Continue button opens the next page to continue creating your account SLR Group Administrator User Guide 14 Create Account Is This You NPI TIN Medicaid ID Name Address Active v True e No Go Back j Yes Continue p All records that match the NPI or TIN will be displayed including any records with an inactive status Only those records with an active status can be used to create an account If the information is not correct select the No Go Back button to return to the previous page From there you can either retry entering your NPI and TIN or
22. Montana State Level Registry for Provider Incentive Payments Group Administrator User Manual State Level Registry tor Provider Incentive Payments April 2014 Version 3 1 Revision History Version Number Date Description Author 1 0 11 16 2010 Draft document Annie Washington Madhuri Pamidipati David Morton guide into EP EH and Group versions 2 17 2012 Revising to the V2 interface Will Graeter 2 27 2012 Added Xerox branding material Will Graeter 2 1 6 11 2012 Added Account Creation Is This You Will Graeter and EHR Reporting Period Add New Location instructions 11 1 2012 2 4 updates including Payee Medicaid Will Graeter ID 1 13 2013 Updates from the 2 5 release Will Graeter 2 6 8 8 2013 Updates from the 2 6 release including Will Graeter Appeals and expanded Recoupments and Adjustments 3 1 4 22 2014 New table of CQMs MU content Will Graeter changes and password period changes Confidentiality Statement This document is produced for Xerox Government Health Solutions and its State clients and cannot be reproduced or distributed to any third party without prior written consent No part of this document may be modified deleted or expanded by any process or means without prior written permission from Xerox 2014 Xerox Corporation All rights reserved XEROX and XEROX and Design are trademarks of the Xerox Corporation in the United States and or other countries Other company trademarks a
23. The process of identifying the most accurate list of all medications that the patient is taking including name dosage frequency and route by comparing the medical record to an external list of medications obtained from a patient hospital or other provider The National Provider Identifier NPI is a Health Insurance Portability and Accountability Act HIPAA Administrative Simplification Standard The NPI is a unique identification number for covered health care Providers EULA Webopedia QuinStreet Inc Date accessed November 22 2010 12 Health Insurance Portability and Accountability Act of 1996 CMS Centers for Medicare amp Medicaid services Public Law 104 191 104 Congress Date accessed November 22 2010 13 HITECH and Funding Opportunities The Office of the National Coordinator for Health Information Technology United States Department of Health amp Human Services Date accessed November 22 2010 14 National Provider Identifier Standard NPI Overview CMS Centers for Medicare amp Medicaid services United States Department of Health amp Human Services Date accessed November 22 2010 SLR Group Administrator User Guide Term Acronym Observation Services Method Office of the National Coordinator ONC for Health Information Technology Office Visit Patient Authorized Entities Patient Specific Education Resources Permissible Prescriptions Preferred Langu
24. a Medicaid Providers to participate Diligent oversight of the incentive program including routine audits and quality assurance checks of meaningful use attestations and reporting mechanisms Coordination with community partners to help encourage the adoption of certified EHR technology and the electronic exchange of health care information To streamline the process in applying for the incentive and provide supportive resources throughout your HIT transition this web portal centralizes the national state and regional links for additional program information It also serves as the portal to access Montana s State Level Registry SLR In support of Montana s vision of this site also offers the following Acentralized one stop launching pad of available tools for managing your EHR Incentive information Organized information offering real time feeds of current HIT news and updates from other federal organizations Educate yourself today on the benefits of HIT and be a part of transforming the quality efficiency and safety of healthcare delivery Regional Extension Centers REC ali inks open in new window jlo Shalth Technology Sevics REGIONAL E a dision of MO NSION CENTER NPAC T www hisroc com 406 457 5838 Ty HEALTH The Montana Regional Extension Center is a federally funded resource that provides technical assistance to help primary care providers with EHR selection and implementation More information
25. additional follow up visits with a practitioner within 270 days 9 months after the Initiation Phase ended CMS169 Bipolar Percentage of patients with depression or Clinical Disorder and bipolar disorder with evidence of an initial Process Major assessment that includes an appraisal for Effective Depression alcohol or chemical substance use ness Appraisal for alcohol or chemical substance use CMS141 Colon Cancer Percentage of patients aged 18 through 80 Clinical Chemotherapy years with AJCC Stage IIl colon cancer who Process for AJCC are referred for adjuvant chemotherapy Effective Stage IIl Colon prescribed adjuvant chemotherapy or have ness Cancer previously received adjuvant chemotherapy Patients within the 12 month reporting period CMS140 Breast Cancer Percentage of female patients aged 18 years Clinical Hormonal and older with Stage IC through IIIC ER or Process Therapy for PR positive breast cancer who were Effective Stage IC IIIC prescribed tamoxifen or aromatase inhibitor ness SLR Group Administrator User Guide 48 Estrogen Al during the 12 month reporting period Receptor Prog esterone Receptor ER PR Positive Breast Cancer CMS62_ HIV AIDS Percentage of patients regardless of age Clinical Medical Visit with a diagnosis of HIV AIDS with at least Process two medical visits during the measurement Effective year with a minimum of 90 days
26. age 1 Current Password text field enter your current password in this field 2 New Password text field enter a new password 3 Confirm New Password text field enter the new password to confirm it in this field 4 Change Password button click this to change the password and open the My Account page 5 Cancel and return to My Account link opens the My Account page without making a change c Select a Challenge Question pull down menu select a new Challenge Question d Your Answer to the Challenge Question text field if you select a new Challenge Question enter a new answer to the Question e Phone text field displays your current phone number and allows you to change it f Email Address text field displays your current email address and allows you to change it g Save My Account button saves any updated information you entered on this page Cancel and lose My Account changes link clears the information you have entered SLR Group Administrator User Guide 18 My Account Make changes to your account below Changing the contact information here does not change the contact information set up under the About You page or the contact information provided to CMS in the registration process SLR generated messages will be sent to all email accounts recorded for this provider UserID msepo4 Password Click H han Select a Challenge Question What is your favorite or dream destination w Your
27. age Prescription Explanation Expansion The denominator should include the following visits to the ED e The patient is admitted to the inpatient setting place of service POS 21 through the ED In this situation the orders entered in the ED using certified EHR technology would count for purposes of determining the computerized provider order entry CPOE Meaningful Use measure Similarly other actions taken within the ED would count for purposes of determining Meaningful Use e The patient initially presented to the ED and is treated in the ED s observation unit or otherwise receives observation services Patients who receive observation services under both POS 22 and POS 23 should be included in the denominator The Office of the National Coordinator for Health Information Technology ONC is the principal Federal entity charged with coordination of nationwide efforts to implement and use the most advanced health information technology and the electronic exchange of health information Office visits include separate billable encounters that result from evaluation and management services provided to the patient and include 1 Concurrent care or transfer of care visits 2 Consultant visits or 3 Prolonged Physician Service without Direct Face To Face Patient Contact tele health A consultant visit occurs when a provider is asked to render an expert opinion service for a specific condition or problem by a referring pr
28. age and select a minimum of five of the Menu Objectives in general When Menu Objectives are selected from the Menu Selection page the selections will appear as options in the Navigation Menu when the Save amp Continue button is selected on the page Other than being selected Menu Objectives are similar in structure and content to the Core Objectives 10 Clinical Quality Measures Import This page allows providers to import CQM data in the same way the associated page allowed the import of Core and Menu objective data Data imported in this manner will display on the individual CQM Detail pages as read only data Validation performed on individual pages will be enforced and the appropriate visual indicators will be displayed in the navigation tree SLR Group Administrator User Guide 40 Clinical Quality Measures Import Instructions Use the CQM Import functionality to import your Core and Menu Objective data The import function will import all records in the file or none of the records in the file if an error occurs with the import The data imported will display on the individual COM pages as read only All validations performed on the CQM pages shall apply and shall be used to display the appropriate visual indicators in the navigation tree If all required data is not populated for the CQM data then you will be required to manually enter and save Select the appropriate format used to import your Clinical Quality Measure data File Impor
29. an organization that delivers care such as a hospital and doctor s surgery Eligible Hospital EH For the purposes of the Medicaid EHR Incentive Program and SLR applications documentation an eligible hospital EH is defined as the following Acute care hospitals including Critical Access Hospitals and cancer hospitals with at least 10 Medicaid patient volume Children s hospitals no Medicaid patient volume requirements Eligible Professional EP For the purposes of the Medicaid EHR Incentive Program and SLR application documentation an eligible professional EP is defined as the following Physicians primarily doctors of medicine and doctors of osteopathy Nurse practitioner Certified nurse midwife Dentist Physician assistant who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant To qualify for an incentive payment under the Medicaid EHR Incentive Program an EP must meet one of the following criteria Have a minimum 30 Medicaid patient volume Have a minimum 20 Medicaid patient volume and is a pediatrician Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30 patient volume attributable to needy individuals Children s Health Insurance Program CHIP patients do not count toward the Medicaid patient volume criteria 7 Electronic Health Records Overview CMS Cent
30. atives will handle the communication with providers regarding all Recoupments SLR Group Administrator User Guide 62 Attaching Files The Attach Documentation Section Attach Documentation sections are available in several pages of the SLR These identify documents that must be attached like a Cost Report Software Sales contract and the Attestation Agreement itself and identify documents that are optional Attach Documentation The e e required The e e i fh e ette e Re File Name Subject Fully Executed Contract g vendor Letter E f Add Files Remove Selected X A table lists those attachments that have already been added to the section in three columns 1 File Name column the name of the uploaded file Selecting the filename will open the file for viewing provided your PC has an application that can open the file 2 Subject column the subject of the uploaded file selected by the user when the file was attached 3 Selecting a checkbox in the unnamed column and clicking the Remove Selected button will remove the file from the list and delete the file from SLR Attach Documentation The following attachments are optional P Eligibility Workbook Practice Management Report Other Please Describe File Name Subject Remove blank doc docx Practice Management Report Add Files Remove Selected X Clicking the Add Files button opens the Add Files pop up window 1 Close icon
31. box selecting this checkbox indicates that you agree with the associated statement 2 Print EULA link clicking this link will open a new window containing a printable version of the EULA A Print window will also open Continue button opens the SLR home page 4 Cancel and return to Log in link returns you to the Login page SLR Group Administrator User Guide 17 Changing Your Password Your password will be effective for 60 days When you log in and 60 days have passed since you created the previous password a Reset Password page will appear You can change your password on this page 1 After 60 days the Reset Password page displays New Password text field enter a new password a b Confirm New Password text field enter the password again 9 Save button selecting this button saves your new password d Cancel button clears entries made into the two text fields above and no change is made to your password 2 Voluntary Password Change To change your password before the 60 days have passed select the My Account link in the top right hand corner of the SLR Home page In addition to changing your password you can also update contact information or change your Challenge Question or answer on this page The My Account page displays the following a User ID text field displays your current User ID and allows you to change it b Password link select the Click Here to Change link to open the Change Password p
32. caid and Medicare patients in rural communities An advantage of RHC status is enhanced reimbursement rates for providing Medicaid and Medicare services in rural areas Those conditions listed in the active patient problem list The State Level Registry SLR is a Xerox application created for the capture and maintenance of state mandated information related to the payment of provider incentive payments provided for under the ARRA A Taxpayer Identification Number TIN is an identification number used by the Internal Revenue Service IRS in the administration of tax laws The movement of a patient from one setting of care hospital ambulatory primary care practice ambulatory specialty care practice long term care home health rehabilitation facility to another In computing a Uniform Resource Locator URL is a Uniform Resource Identifier URI that specifies where an identified resource is available and the mechanism for retrieving it 16 Taxpayer Identification Numbers TIN IRS gov Internal Revenue Service Last modified August 20 2010 Date accessed November 22 2010 17 Uniform Resource Locator SLR Group Administrator User Guide Wikipedia The Free Encyclopedia Wikimedia Foundation Inc Last modified November 22 2010 Date accessed November 22 2010 73 Term Acronym Unique Patient Up to date SLR Group Administrator User Guide Explanation Expansion If a patient is seen b
33. call the Help Desk for assistance If the information is correct and you click the Yes Continue button The following section will appear on the page 1 User ID text field enter a User ID Number This must be at least 8 letters and or numbers long but not more than 20 letters and numbers 2 Password text field enter a password Your password also needs to be at least 8 letters and numbers long and must be less than 20 letters numbers When you are choosing a password you also need to make sure to include the following e At least one capital letter e At least one lower case letter e Atleast one number e Atleast one of the following special characters or or Your password cannot be your User ID or your User ID spelled backwards Confirm Password text field enter the password you entered above to confirm it Select a Challenge Question pull down menu select an option from the pull down menu as a Challenge Question to answer 5 Your answer to the Question text field enter an answer for the Challenge Question that you selected above You ll need this information if ever forget your User ID or password 6 Phone Number text field enter your phone number as a ten digit number with no spaces dashes or parentheses 7 Email Address text field enter your email address 8 Confirm Email Address text field enter your email address again to ensure it was not misspelled 9 Create Account button select this button t
34. chnology information for all providers you are managing radio button select the Yes radio button to apply the EHR Technology you enter on this page to all the members of the Group The Your Understanding section will appear 2 Your Understanding section click the checkbox to affirm your responsibility The Your EHR Certification Information section will appear 3 Your EHR Certification Information section contains a field and instructions for retrieving the correct EHR Certification Number from the ONC website e EHR Certification Number text field enter your group s EHR Software s Certification Number in the EHR Certification Number field The field will be validated when the Save Certified EHR Technology button is selected Your EHR Certification Information EHR Certification Number Q000000010C7MAA d SLR Group Administrator User Guide 57 4 Supporting Documentation section use this component to add a contract Work plan Action plan or other document associated with your practice s EHR software A document is not required on this page Supporting documentation The following attachments are optional P File Name Subject No records to display Add Files 4 Remove Selected 5 Save Certified EHR Technology button saves the EHR system information Save Certified EHR Technology Fj Cancel and lose Certified EHR Technology changes 6 Cancel and lose certified EHR Technology changes l
35. clicking the blue X in the upper right hand corner closes the Add Files window without attaching a file 2 Subject pull down menu select an option to identify what type of document or documents you are attaching These will be restricted to subjects that are appropriate for the section of SLR you are viewing 3 File s Subject display field this displays the default subject This is populated when a document is selected SLR Group Administrator User Guide 63 4 Description text field if the Other Please Describe option is selected from the Subject pull down menu this field will appear It requires the user to enter a brief description of the document being attached 5 File Name text field the file name will display once it is selected Select button allows you to select the file you would like to attach from a local drive 7 Remove icon clicking this removes file reference from the window It will not be imported 8 Add button adds another File field and Select button to allow the user to attach another file The file will be added under the same subject as the file above it 9 Attach button adds the document or documents that were selected 10 File s Attached X message allows you to know the number of files currently attached for this specific page 11 Cancel and lose file changes button this will close the window discarding any changes Add Files You may atiach files with multiple subjects using this
36. counters for the medically needy patients you serve 30 i More info link opens a pop up window that explains what CMS considers medically needy patients j Eligibility Formula 1 section select this formula for your eligibility calculation to use total patient encounters and total Medicaid encounters as well as the medically needy patient encounters if applicable to calculate your result i Use this formula radio button indicates you are using this formula ii Calculate button calculates the results of Eligibility Formula 1 If the numbers qualify a message will be displayed below the section Practice Eligibility Details Enter your eligibility information below Red asterisk indicates a required field Enter Representative Period 90 day period m Year 2 Start Date 4 4 2011 Al Year 2 End Date Total Encounters 499 Please enter your total patient encounters for the selected reporting period Total Medicaid Encounters 43 Please enter your total Medicaid Patient Encounters for the selected reporting period Do you have Medicaid Patients O from more than one State Yes No Do you practice predominately in a Federally Qualified Health ie N O O Care Center FQHC Rural FQHC RHC IHS MOA IHS None Health Center RHC or Indian Health Service IHS MOA Eligibility Formula 1 Calculate s Meets Medicaid Eligibility Requirements section messages will instruct you about
37. cting an option from the menu As an individual physician or medical professional select Individual Eligible Professional NPI text field enter your National Provider Identifier NPI number If you have more then one NPI use the one that you used while registering with the CMS Medicaid EHR Incentive Program Registration Site If the number entered is not recognized an error message will appear and you will not be able to proceed TIN text field enter your Taxpayer Identification Number TIN which is either your Employer Identification Number EIN or your Social Security Number SSN CAPTCHA image a computer generated image Generate New Image link refreshes the image above if you are unsure of what numbers and letters are being displayed Enter the letters numbers from the image above text field enter the letters and or numbers you see in the CAPTCHA image This is a security feature Continue button select this button to open the SLR You will confirm your name and the address associated with your NPI and TIN Cancel and return to Login link opens the Login page SLR Group Administrator User Guide 13 Create Accoun lf you are an Eligible Prof oup Practice Clinic Representative you cation information to start the process of Identify Yourself Enter the necessary information below and click Continue Red asterisk indicates a required field What is your role Select a role NPI TIN
38. d the result fails the criteria set a failed icon will appear If even one Core Objective fails to meet its minimum criteria the Attestation will fail Providers must enter all Core Objectives and these are listed in the Navigation Menu when the MU Attestation Type is selected Core Objectives generally consist of an acknowledgement that you have met the obligations or a Numerator and a Denominator There are different numbers of Core Objectives for the different stages of Meaningful Use For example for the Objective Maintain Active Medication List the user would enter the number of unique patients seen by the EP during the EHR reporting period as a Denominator In the Numerator field the user would enter the number of patients in the denominator who have a medication recorded as structured data added to the number of patients that are not currently prescribed any medication Objectives also have a measure validation if the Numerator divided by the Denominator and rendered as a percentage does not exceed the percentage stated in the Measure field on each Detail page the measure is failed For example Maintain Active Medication List has a Measure of More than 80 of all unique patients seen by the EP have at least one entry or an indication that the patient is not currently prescribed any medication recorded as structured data 9 Menu Objectives Users must select at least one of the Public Health Objectives on the Menu Selection p
39. dd a State l button to add another row to the table a State pull down column select a State to enter the encounter information for that State b Total Encounters column enter the encounters for the State and selected time period C Total Medicaid Encounters column d Total Panel Members column e Total Medicaid Panel Members column f Insert link adds the numbers to the multi State table Cancel link cancels the operation Remove link This will remove the associated row Select the Add a State ij button to add another row to the table Total Montana Medicaid Panel Members Assigned text field enter your total assigned Panel Members Panel Members are patients for whom you receive capitation payments Panel members are members seen in the calendar year This is help text that defines panel members Total Panel Members Seen text field enter the total number of Panel Members that you have seen during the period Panel Members are patients for whom you receive payments on other than a fee for service basis Do you practice predominately in a Federally Qualified radio buttons select one of the buttons if you practice more than 50 of the time in one of these types of health center This field is required for Physician s Assistants who must practice in a FQHC RHC or IHS i If you select any option besides None a Medically Needy Individuals Patient Encounters text field will appear Enter your patient en
40. ddress text field enter the contact s email address Initially this defaults to the address that was entered when the User Account was first created Contact Person ed to CMS in the registration proces Enter your contact information below Contact Person Name Title Program Manager Phone Number Email Address 6 Attach Documentation section if needed you may attach documents such as a Board Certification using this component 7 Save amp Continue button saves the information you entered If you have left a required field blank or entered information incorrectly an error message will appear Once all required fields are completed this section will be marked as complete The 2 Confirm Medicaid Eligibility page will open 8 Cancel and lose About You changes link clears the page of any information you have just entered and returns you to the Home page a After completing this information you can proceed to your eligibility information by selecting the Save amp Continue button The status icon on your home page will change to indicate that your registration section is complete The green background of the first section and the icon indicate that this section has been completed Now that you have entered your registration you can move onto completing your eligibility information by returning to the dashboard and selecting the next step Also the status icon on your home page will change to indicate that
41. ders must register with the CMS registration and attestation system formerly known as NLR prior to registering with the Montana State Level Registry The tools in this Provider Outreach Page will help you start collecting and organizing the information you will need in order to register with Montana s SLR As the healthcare landscape continues to modemize recent o j legislation was passed to encourage the adoption of Electronic Healthcare Record EHR technology in Want to get a documenting patient care As a result of the American jump start Recovery and Reinvestment Act of 2009 beginning in 2011 eligible Medicaid providers are offered financial incentives for the implementation and meaningful use of Health Information Technology HIT in the management of patient populations The State of Montana Department of Public Health and Human Services has elected to participate in the HIT incentive program Our primary goal is to provide an effective means of administering and distributing incentive monies to eligible providers and hospitals including establishing a process to determine eligibility and track meaningful use The Department s objectives in this process include The implementation of a cost effective fully automated and auditable process to administer incentive payments to eligible providers and hospitals Development of incentive program administrative rules designed to maximize the opportunity for Montan
42. dit link enables fields for modifications in an inserted row to be modified Select the Add New Location l button to add another row to the table e Select the Meet the Additional CMS Regulations and Following Statements checkboxes to indicate that you agree with the associated statements E agree that meet the additional CMS regulations for attesting to Meaningful Use understand that the State may choose to audit my records to verify that m e regulations C agree with the following statements The information submitted for clinical quality measures CQMs was generated as an output from an identified certified EHR technology The information submitted is accurate to the knowledge and belief of the EP or the person submitting on behalf of the EP eligible hospital or CAH The information submitted is accurate and compiete for numerators denominators exclusions and measures applicable to the EP eligibie hospital or CAH The information submitted includes information on all patients to whom the measure applies f For the first year only data captured during a 90 day period is required though a full year is required after that The Start Date and End Date must fall within the current calendar year Reporting AlU is First Year MU is First Year Year 1 None 90 days Stage 1 MU Year 2 90 days Stage 1 MU Calendar year Stage 1 MU Year 3 90 days if Year 3 is 2014 90 days if the Year 3 is 2014
43. dult Major Percentage of patients aged 18 years and Clinical Depressive older with a new diagnosis of major Process Disorder depressive disorder MDD with a suicide risk Effective MDD Suicide assessment completed during the visit in ness Risk which a new diagnosis or recurrent episode Assessment was identified CMS128 Anti Percentage of patients 18 years of age and Clinical depressant older who were diagnosed with major Process Medication depression and treated with antidepressant Effective Management medication and who remained on ness antidepressant medication treatment Two rates are reported a Percentage of patients who remained on an antidepressant medication for at least 84 days 12 weeks b Percentage of patients who remained on an antidepressant medication for at least 180 days 6 months CMS136 ADHD Follow Percentage of children 6 12 years of age and Clinical Up Care for newly dispensed a medication for attention Process Children deficit nyperactivity disorder ADHD who Effective Prescribed had appropriate follow up care Two rates ness Attention are reported Deficit Hyperac a Percentage of children who had one tivity Disorder follow up visit with a practitioner with ADHD prescribing authority during the 30 Day Medication Initiation Phase b Percentage of children who remained on ADHD medication for at least 210 days and who in addition to the visit in the initiation Phase had at least two
44. e with a diagnosis of low back pain who did not have an imaging study plain X ray MRI CT scan within 28 days of the diagnosis Percentage of children 3 months 18 years of age who were diagnosed with upper respiratory infection URI and were not dispensed an antibiotic prescription on or three days after the episode Efficient Use of Healthcare Resources Efficient Use of Healthcare Resources Efficient Use of Healthcare Resources Clinical Quality Measures have been renumbered as the NQF references are no longer used The list of CQMs for Eligible Hospitals is in the table below eMeasu re ID SLR Group Administrator User Guide Title Description Domain 42 Adult Recommended Measures CMS165 Controlling Percentage of patients 18 85 years of age Clinical High Blood who had a diagnosis of hypertension and Process Pressure whose blood pressure was adequately Effective controlled lt 140 90mmHg during the ness measurement period CMS156 Use of High Percentage of patients 66 years of age and Patient Risk older who were ordered high risk Safety Medications in medications Two rates are reported the Elderly a Percentage of patients who were ordered at least one high risk medication b Percentage of patients who were ordered at least two different high risk medications CMS138 Preventive Percentage of patients aged 18 years and Popula Care and older who we
45. elect only some of the measures Users cannot select a measure on the Core CQM or Core Objective Selection pages since all core measures are required Each measure within a group also includes a Detail page where users will record the applicable data Select the Save amp Continue button on each measure Detail page to move unto the next measure requiring input or the next Selection page Detail pages include an Attach Documentation section so that users can associate a document that is relevant to the measure 7 Exclusions Sometimes the measure will not apply to your particular practice Pediatricians for example have no patients over 65 years old To account for this measures of this nature include Exclusion Yes and No radio buttons The measure s data fields will appear if the Exclusion does not apply There can also be more than one Exclusion per Measure SLR Group Administrator User Guide 39 Questionnaire 1 of 17 2 Red asterisk indicates a required field Objective Use computerized provider order entry CPOE for medication laboratory and radiology orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state local and professional guidelines Measure 1 More than 60 of medication orders created by the EP during the EHR reporting period are recorded using CPOE Exclusion 1 Any EP who writes fewer than 100 medication orders during the EHR reporting period would be
46. em messages d Individual messages Clicking on one of the individual message links will reveal a message i The first line indicates the window title ii Subject display field SLR Group Administrator User Guide 23 iii Date Received display field the date the message was sent iv From display field the sender the message v Message Text section the message text 6 Workflow section Detailed further below located to the right of the page the Workflow section displays the following items that are visible on the home page a Year x tabs each tab represents a year in which you have completed an attestation The most current year s tab will always be the one visible when you log in Click other tabs to view a previous year s information IB b Sections each section has a Status icon that indicates whether each page has been started whether the page has been completed or whether it is still locked A locked page cannot be accessed until the previous pages have been completed Each section will also have a description The title of each section provides a link to that section i About You ii Confirm Medicaid Eligibility iii Attestation of EHR This link will not be active until you ve already completed your registration and eligibility iv Review and Sign Agreement This link will not be active until you have completed the Attestation of EHR section v Send Year X Attestation This link wi
47. ement You have the ability to remove and attach different files until you submit your final attestation 3 Save amp Continue button saves the information you have entered on this page and opens the Home page 4 Cancel and lose Review changes link clears the page of any information you have just entered and opens the Home page Once you have successfully saved the signed attestation the status icon on your home page will change to indicate that Step 4 is complete The system will now let you move onto Step 5 Step 5 Send Year X Attestation Details Clicking the Send Year X Attestation link opens a pop up window allowing you to send your attestation to the State The Send Attestation to State window displays the following 53 SLR Group Administrator User Guide 1 Send Attestation button clicking this will submit your attestation application to the State All steps in the workflow section of your home page will be locked down You will not be able to make any more changes to the section but can still view the information you entered on a report The Send Attestation to State window will appear displaying the expected time period for payment and other payment related information 2 Cancel and Do No Send link returns you to the Home page After sending the Attestation Agreement a System Message will arrive that designates the time and date System Messages 1 Subject Date Received From Your attestation has bee
48. ered those correctly the system will email a link to reset your password to the email address you entered when you created your account 6 Create Account button select this if you need to create a new SLR account Existing Users Need to Create an Account Enter the User ID and p word you created to login to the SLR If you have not already created a User ID please select the Create Account option to create a new User ID Red asterisk indicates a required field please select the Create Account button below User ID User ID Password Create Account 9 Login Forgot User ID Forgot Password SLR Group Administrator User Guide 12 Creating a New SLR Account for Eligible Professionals and Group Representatives To create a new account from the Provider Outreach page select the leave this site and create an SLR account link located on the left side of the Provider Outreach Jumpstart page To create a new account from the Login page select the Create Account button Need to Create an Account o If you are an Eligible Professional Eligible Hospital Representative or Group Practice C epresentative you can create a user account for ti u have not already created a User ID please select the C ccount button below to create a new User ID Create Account 9 The Create Account page displays the following 1 What is your role pull down menu identify your Provider Type by sele
49. ers for Medicare amp Medicaid services United States Department of Health amp Human Services Date accessed November 22 2010 8 Electronic medical record Wikipedia The Free Encyclopedia Wikimedia Foundation Inc Last modified November 5 2010 Date accessed November 22 2010 EHR Incentive Programs Eligibility Eligible Hospitals CMS Centers for Medicare amp Medicaid services United States Department of Health amp Human Services Date accessed November 22 2010 10 EHR Incentive Programs Eligibility Eligible Professionals United States Department of Health amp Human Services Date accessed November 22 2010 SLR Group Administrator User Guide 70 Term Acronym End User License Agreement EULA Exchange Federally Qualified Health Center FQHC Health Insurance Portability and Accountability Act of 1996 HIPAA Health Information Technology HIT Health Information Technology for Economic and Clinical Health Act of 2009 HITECH Medication Reconciliation National Provider Identifier NPI Explanation Expansion The End User License Agreement EULA details how the software can and cannot be used Clinical information must be sent between different legal entities with distinct certified EHR technology and not between organizations that share a certified EHR technology Distinct certified EHR technologies are those that can achieve certification and operate independe
50. es of certified EHR technology that link to a common uncertified system or component would be considered distinct Instances of certified EHR technology can be from the same vendor and still be considered distinct EHR Provider Incentive The EHR Provider Incentive Portal SLR is a Xerox application created for Portal SLR the capture and maintenance of state mandated information related to the payment of Provider incentive payments provided for under the ARRA 5 Grumman nets 34M CMS data repository project CMIO Contracts and Installations TriMed Media Group Inc Article date May 17 2010 Data accessed November 22 2010 i Computerized Provider Order Entry AHRQ Agency for Healthcare Research and Quality United States Department of Health amp Human Services Date accessed November 22 2010 SLR Group Administrator User Guide 69 Term Acronym Explanation Expansion Electronic Health Record An Electronic Health Record EHR is an electronic version of a patients EHR medical history that is maintained by the Provider over time and may include all of the key administrative clinical data relevant to that persons care under a particular Provider including demographics progress notes problems medications vital signs past medical history immunizations laboratory data and radiology reports Electronic Medical Record An electronic medical record EMR is a computerized medical record EMR created in
51. estation section a lattest checkboxes you must agree to one of three statements in order to be eligible to continue the standard or a Pediatrician or Physician Assistant statement Agree by clicking the checkbox next to the appropriate statement b Why is this important Link clicking this opens a pop up window explaining why you need to agree to this qualification SLR Group Administrator User Guide 25 Attestations attest that I DO NOT perform 90 or more of my Montana Medicaid Program services in an inpatient hospital POS 21 or emergency room POS 23 setting Why is this important 7 C Iattest that ama pediatrician and am eligible for a reduced incentive payment if achieve 20 Montana Medicaid Program eligibility 7 o attest that am a Physician Assistant that practices predominantly in a PA led FQHC or RHC oS 4 License Information section Not all of the fields listed below will appear for all states a Do you practice primarily in a Tribal Health Clinic or other Federal clinic without a Montana license radio buttons if you select the Yes radio button the Other License Number and Other License State fields display 1 Other License Number text field enter a professional license number from another state If you are only licensed in Montana then enter your Montana Professional License Number 2 Other License State pull down menu This is where you choose the state that issued your other licen
52. excluded from this requirement Exclusion from the requirement does not prevent the EP from achieving meaningful use Does this exclusion apply to you Yes No Measure 2 More than 30 of laboratory orders created by the EP during the EHR reporting period are recorded using CPOE Exclusion 2 Any EP who writes fewer than 100 laboratory orders during the EHR reporting period would be excluded from this requirement Exclusion from the requirement does not prevent the EP from achieving meaningful use Does this exclusion apply to you Yes No C Measure 3 More than 30 of radiology orders created by the EP during the EHR reporting period are recorded using CPOE Exclusion 3 Any EP who writes fewer than 100 radiology orders during the EHR reporting period would be excluded from this requirement Exclusion from the requirement does not prevent the EP from achieving meaningful use Does this exclusion apply to you Yes C No Complete the following information Numerator The number of orders in the denominator recorded using CPOE Denominator Number of radiology orders created by the EP during the EHR reporting period Numerator Please enter a numerator Denominator Please enter a denominator 8 Core Objectives Objectives measure how much of a provider s patient population has been entered into the EHR software for certain reasons If the user selects the Save amp Continue button with all fields completed on a page an
53. he Enter key on your keyboard https mt arraincentive com SLR login from the Provider Outreach Web portal You can access the SLR Web application from the Provider Outreach Web portal This webpage features provider education resources related to the American Reinvestment and Recovery Act ARRA and the Health Information Technology for Economic and Clinical Health HITECH act and also provides a link to the SLR application login page The Provider Outreach page displays the following 1 Montana banner section Located at the top of the page the banner displays the following items that are visible on every page of the SLR application a Client logo and tagline This is the Montana Department of Public Health and Human Services logo and with SLR tagline b SLR heading Montana Medicaid State Level Registry for Provider Incentive Payments This is the name of the application c Provider Outreach Home link Clicking this link returns you to the Provider Outreach Home page d Contact Us link Clicking this link opens a pop up page displaying contact information consisting of the ACS Help Desk phone number and email 2 SLR Account Creation Entry FAQs and RSS Feeds sections Located to the left and right of the page these columns display the following sections a Deadlines for Calendar Year Montana Medicaid EHR Incentive Payment Applications section contains links to information for both eligible professionals and e
54. ice of the National Coordinator ONC The ONC Certified HIT Product List CHPL contains the list of all certified EHR technology products and is used by the providers to generate the unique EHR Certification ID that represents the system or combination of modules that is capable of meeting Meaningful Use The State is required to validate the verification of the Certified EHR information before making any payment to providers It is the provider s responsibility to generate an EHR Certification ID that accurately reflects the complete EHR or combination of modules representing a complete EHR used by the provider before attesting to the State Failure to do so could result in a false negative result that may disqualify the provider from receiving payment To proceed please indicate your understanding of this responsibility by agreeing to the following statement A more info I understand that it is my responsibility as the provider to ensure that my certified EHR technology code is listed on the ONC public web service before submitting my attestation to the State understand that failing to ensure my code is listed may result in a false negative result that may disqualify me from receiving payment Save amp Continue gt Cancel and lose EHR Certification cha 3 EHR Reporting Period page CMS requires that providers meet specific regulations for attesting to Meaningful Use This page contains checkboxes and EHR Reporting Peri
55. ich the eligible Safety Medications in professional attests to documenting a list of the Medical current medications to the best of his her Record knowledge and ability This list must include SLR Group Administrator User Guide 50 and route of administration CMS132 Cataracts Percentage of patients aged 18 years and Patient Complications older with a diagnosis of uncomplicated Safety within 30 Days cataract who had cataract surgery and had Following any of a specified list of surgical procedures Cataract in the 30 days following cataract surgery Surgery which would indicate the occurrence of any Requiring of the following major complications retained Additional nuclear fragments endophthalmitis Surgical dislocated or wrong power IOL retinal Procedures detachment or wound dehiscence CMS177 Child and Percentage of patient visits for those patents Patient Adolescent aged 6 through 17 years with a diagnosis of Safety Major major depressive disorder with an Depressive assessment for suicide risk Disorder Suicide Risk Assessment CMS179 ADE Jann Average percentage of time in which Patient Prevention and patients aged 18 and older with atrial Safety Monitoring fibrillation who are on chronic warfarin Warfarin Time therapy have International Normalized Ratio in Therapeutic INR test results within the therapeutic range Range i e TTR during the measure
56. ide Term Acronym Explanation Expansion Problem List A list of current and active diagnoses as well as past diagnoses relevant to the current care of the patient Provider Public Health Agency For the purposes of the EHR Provider Incentive Portal SLR application documentation a Provider refers to both EPs and EHs An entity under the jurisdiction of the U S Department of Health and Human Services tribal organization State level and or city county level administration that serves a public health function Recoupments A Recoupment is a return to the State of the full amount paid to the provider for a Payment Year An encounter during which the provider performs a medication reconciliation due to new medication or long gaps in time between patient encounters or for other reasons determined appropriate by the provider Essentially an encounter is relevant if the provider judges it to be so Note Relevant encounters are not included in the numerator and denominator of the measure for this objective Relevant Encounter Rural Health Clinic RHC Specific Conditions State Level Registry SLR Taxpayer Identification Number TIN Transition of Care Uniform Resource Locator URL RHCs must be located in rural underserved areas and must use one or more physician assistants or nurse practitioners RHCs can be public private or non profit and are intended to increase primary care services for Medi
57. if you belong to more than one Group Once you select a Group that Group s eligibility numbers will populate this page Select this checkbox and then select a different Group from the pull down menu below to change your Group affiliation b Do you want to use Group practice eligibility information radio buttons select the Yes radio button to use the eligibility numbers of your Group or practice Select the No radio button to use only your own patient encounter numbers c More info link opens a pop up explaining how Groups work in SLR The most important thing to remember is this CMS rules dictate that all professionals within a Group or clinic must use the same methodology for determining Medicaid eligibility If you elect to opt out of using the Group volumes all other professionals within your Group will be unable to use the Group volumes to determine their eligibility All providers associated with that Group will have to use individual volumes d I practice in more than one Group clinic and am electing to use volumes from Group pull down menu After clicking the checkbox select the Group you wish to be associated with e I practice in both a group clinic and my own practice radio button this field appears if the No radio button in the Group Practice Eligibility Information field is selected Users select this button to use patient volumes in their own practice rather than the group to which they are affiliated Clicking thi
58. ing to the adoption implementation or upgrade A VU to certified EHR technology the second year payment is based on Meaningful Use Registration and attestation for a 2012 payment must be made by the dates specified below Click here to leave this site and create an SLR account for accessing the Montana Medicaid EAR incentive Program ste Aen have an LR account Already have an SLR Ao Click here to go directly to the State Level Centers for Medicare amp Medicaid Services CMS Beginning January 3 2011 the Electronic Health Record EHR Information Center will be open to assist the EHR Provider Community with both program and system inquiries from 7 30 a m 6 30 p m Central Time Monday through Friday except federal holidays at 1 888 734 8433 primary number or 888 734 6583 TTY number a more info all inks open in new window Oct 12 2012 People with Medicare have More high quality choices Oct 04 2012 Medicare Fraud Strike Force Charges 91 dusts F 430 Mil False Biling Sep 27 2012 EMR and HIPAA all inks open in new window Oct 22 2012 to include Meaningful EHI incent vi Meani iL Mi Oct 21 2012 MR Uj ws Tablet and f Errors Heal Scene Oct 20 2012 Data Capture Electronic Data and Terms of Use and Aftaiat Welcome to the Montana State Level Registry SLR Provider Outreach Page Montana provi
59. ink this will cancel any changes made to this page The page will refresh restoring the original values and files to the fields on the page 7 lt lt Back to Dashboard Select this link to return to the Group Home page Once you have successfully saved the information in the Group Certified EHR Information page the status icon on your Home page will change to indicate that the Group Certified EHR Information section is complete The system will move you to Step 4 Step 4 Manage Providers in Your Group Clicking the Manage Providers in Your Group link on the Group Home page or in the Navigation Menu opens Step 4 of the process This page allows you to search for and add Eligible Professionals to your Group They must exist in the SLR database before they can be added so they must register with CMS before you perform this step 4 Manage Providers in Your Group re to review carefully as vou do not have the ability to remove a provider f 5 sup ce you ha 1 Providers in Your Group Add Provider Q Locate Provider Last Name First TIN Pymt Multiple Name NPI Number Number Yr Address Specialty Taxonomy Groups 16 No 1 Providers in Your Group section enter the NPI and TIN of the professional you wish to add to the Group and click the Locate Provider button An error message will appear if the professional was not found A pop up confirmation window will appear if the provider was found in the system SLR G
60. ink on the EP Home page directs you to the 3 Attestation of EHR page This lets you select Adopt Implement Upgrade AIU or Meaningful Use MU for your Attestation Type Once you have selected the Attestation Type you will then be able to upload documents related to your EHR Software enter its certification number and enter other information 3 Attestation of EHR The first step of completing this section is to choose the type of attestation You will be able to access this section once you complete the About You and Confirm Medicaid Eligibility pages This page displays the following 1 Attest to Adopt Implement Upgrade button opens the AIU workflow This option is available only in your first year of participating This section contains three pages the AIU Method page and the EHR Certification page in addition to the Attestation of EHR page 2 Attest to Meaningful Use button opens the MU workflow This section contains four to five different sections depending on your selections Each of these sections contains three to 38 pages though not all are required 3 More info link opens the Attestation of AIU information pop up SLR Group Administrator User Guide 32 3 Attestation of EHR Attest to Adopt Attest to Meaningful Use Implement Upgrade more info Note if the user has already completed their first year they must enter MU data and will receive the following message Attest To Meaningful Use Eligible Profe
61. king OK all other providers associated with the group will be unable to use the group clinic volumes to determine their Medicaid volumes You may contact the ACS Help Desk at 866 879 0109 to discuss the implications Clicking Cancel will reset your choice without saving any data Reason for opting out 5 Practice Eligibility Details section This is the section title a Enter Representative Period pull down menu select the appropriate period from which the patient volume numbers will be used SLR Group Administrator User Guide 29 SLR Group Administrator User Guide Year n Start Date text field enter the date of the first day of your representative period The system will automatically display the end date based on the Representative Period 1 Calendar icon Clicking this icon opens up a calendar from which you can click on a date to select it Year n End Date display field the end date of the representative period based on the start date you entered Total Encounters text field enter the total encounters for the period you noted above Total Montana Medicaid Encounters text field enter your total Medicaid encounters for the period Do you want your volumes for all states to be used to determine eligibility radio buttons identify whether or not you want to use the other states volumes to determine your eligibility If you chose the Yes radio button the Add a State component will appear Select the A
62. ligible hospitals b Need to create an SLR account section clicking the leave this site and create an SLR account link directs you to the Create Account page c Already have an SLR account section Clicking the go directly to the State Level Registry for Provider Incentive Payments link directs you to the Login page d Centers for Medicare amp Medicaid Services CMS section clicking a link in this section opens up a new window and displays an article related to CMS SLR Group Administrator User Guide 8 e EMR and HIPAA section clicking a link in this section opens up a new window and displays an article related to one of these healthcare topics f Are you Eligible section clicking the Run the CMS Eligibility Wizard link directs you to a wizard designed by CMS to help you determine basic eligibility to the provider incentive program g Frequently Asked Questions section clicking the view our list of most frequently asked questions link directs you to CMS frequently asked questions website related to electronic health record EHR technologies and the incentive program h Healthcare IT News section clicking a link in this section opens up a new window and displays an article related to Healthcare IT news 3 Primary Page Body Content section Located in the middle of the page the primary page content entails the following sections Welcome text This is an overview of the Provider Outreach Web portal Want to ge
63. ll locations must e Have 50 of their total patient encounters at locations where certified EHR technology is available SLR Group Administrator User Guide 36 e Base all meaningful use measures only on encounters that occurred at locations where certified EHR technology is available Select Add New Location it button and the default address associated with the NPI TIN will be displayed and may be changed if required Any new locations added will require all data to be entered There will be no default values displayed The Add New Location table displays the following i Street text field enter the street ji City text field enter the city iii State pull down list field select a state from the available list iv Zip text field enter the zip code v Numerator text field enter the number of patient encounters entered into the EHR Software at the specified location during the reporting period vi Denominator text field enter the number of patient encounters at the specified location during the reporting period vii EHR Technology pull down list select yes if certified EHR technology was used at the specified location or no if it was not used viii Percentage the percentage of patients entered into the EHR software out of the entire population of patients ix Insert link adds the record to the Add New Location table x Cancel link cancels the operation xi Remove link will remove the associated row xii E
64. ll not be active until you ve reviewed signed and uploaded your signed attestation agreement Once you submit the attestation all of the other sections will be locked for editing and will display your information as view only 7 Footer section Located at the bottom of the page the footer displays the following items a Privacy link clicking this link opens a new window with a Privacy Statement displayed b Terms of Use link clicking this link opens a Legal Statement for the site c Accessibility link clicking this link opens a new window with the website s Accessibility policy displayed d ACS Xerox Copyright This is ACS s copyright symbol and text Workflow Section Details This section describes in more detail the specific steps to take when applying for the Provider incentive This begins with Step 1 the About You section where you will enter your registration and contact information Step 1 About You Section Details Clicking the About You link on the EP Home page directs you to the 7 About You page This is where you enter your registration information The About You page displays the following SLR Group Administrator User Guide 24 1 CMS Medicaid EHR Incentive Program Registration Record section Please note that it can take up to three day for the SLR to receive your data from the CMS a Data has not been received from the CMS Medicaid EHR Incentive Program Registration site message thi
65. ludes instructions to access the ONC website find software and retrieve an EHR Certification Number http onc chpl force com ehrcert Once this number is entered into the EHR Certification Number field and the Save amp Continue button is clicked SLR will validate that the number represents approved software A The Office of the Nation yrdinator for Health Informe e Certified Health IT Product iist A HealthIT HHS Gov The Certified HIT Product List CHPL provides the authoritative comprehensive listing of Complete EHRs and EHR Modules that have been tested and certified under the Temporary Certification Program maintained by the Office of the National Coordinator for Health IT ONC Each Complete EHR and EHR Module listed below has been certified by an ONC Authorized Testing and Certification Body ONC ATCB and reported to ONC Only the product versions that are included on the CHPL are certified under the ONC Temporary Certification Program Please send suggestions and comments regarding the Certified Health IT Product List CHPL to ONC certification hhs gov with CHPL in the subject line Vendors or developers with questions about their product s listing should contact the ONC Authorized Testing and Certification Body ONC ATCB that certified their product USING THE CHPL WEBSITE To browse the CHPL and review the comprehensive listing of certified products follow the steps outlined below 4 Select your practice ty
66. ment for THA who completed baseline and follow up Family hip patient reported functional status Engageme replacement assessments nt CMS90 Functional Percentage of patients aged 65 years and Patient status older with heart failure who completed and assessment for baseline and follow up patient reported Family complex functional status assessments Engageme chronic nt conditions Care Coordination Domain CMS50 Closing the Percentage of patients with referrals Care referral loop regardless of age for which the referring Coordinati receipt of provider receives a report from the provider on specialist to whom the patient was referred report Step 4 Review and Sign Attestation Clicking the Review and Sign Agreement link on the EP Home page directs you to the 4 Review and Sign Agreement page where you will review the attestation agreement Once you have had a chance to review it you must print it out in order to sign it Once signed the agreement must be scanned and then uploaded into SLR The Review and Sign Attestation page displays the following 1 The Step 1 Print to Sign Attestation section contains the Print to Sign button When selected this will open a file Download window allowing you to open or save the Attestation Agreement and print a copy of the document 2 The Step 2 Scan and Upload Signed Attestation section contains an Attach Documentation component that will allow you to upload the Attestation Agre
67. ment period Population Public Health Domain CMS155 Weight Percentage of patients 3 17 years of age Population Assessment who had an outpatient visit with a Primary Public and Care Physician PCP or Health Counseling for Obstetrician Gynecologist OB GYN and Nutrition and who had evidence of the following during the Physical measurement period Three rates are Activity for reported Children and Percentage of patients with height Adolescents weight and body mass index BMI percentile documentation Percentage of patients with counseling for nutrition Percentage of patients with counseling for physical activity CMS138 Preventive Percentage of patients aged 18 years and Population Care and older who were screened for tobacco use Public Screening one or more times within 24 months AND Health Tobacco Use who received cessation counseling Screening and _ intervention if identified as a tobacco user Cessation Intervention CMS153 Chlamydia Percentage of women 16 24 years of age Population Screening for who were identified as sexually active and Public Women who had at least one test for chlamydia Health during the measurement period CMS117 Childhood Percentage of children 2 years of age who Population Immunization had four diphtheria tetanus and acellular Public Status pertussis DTaP three polio IPV one Health measles mumps and rubella MMR three H 51 SLR Group Administrator User Guide
68. ment program contact a Montana representative Email MedicaidEHR mt gov http medicaidprovider hhs mt gov providerpages ehrincentives shtml SLR Group Administrator User Guide Overview As the healthcare landscape continues to modernize legislation was passed to encourage the adoption of Electronic Health Record EHR technology in documenting patient care Because of the American Recovery and Reinvestment Act ARRA of 2009 eligible Medicaid Providers are being offered financial incentives for the implementation and meaningful use of Health Information Technology HIT in the management of patient populations In support of this initiative ACS has developed the EHR Provider Incentive Portal application called the State Level Registry SLR By using SLR you have access to a streamlined application for federally funded HIT incentives through an easy to use website With self service flexibility you can move through registration eligibility and attestation at your own pace while the SLR application stores your information in an organized manner This application provides the most direct path to your incentive payment Dates An EP applying for the 2014 program year will have had Medicaid eligibility dates between 1 1 14 and 12 31 14 Each State has a designated Grace Period in the beginning of the year during which users that have not submitted an Attestation Agreement can elect the year for which they are Attesting Select Attesta
69. n submitted 11 30 2011 4 45 21 PM SLR Group Administrator User Guide 54 Applying for the Incentive as a Group Administrator A Group is a practice or clinic that is comprised of multiple Eligible Professionals All of these individual providers may decide to apply for the EHR Incentive Payment using the patient encounter numbers of the practice or clinic A representative from your Group will serve as the Group Administrator and provide a single point of contact for the State Level Registration of the Medicaid EHR Incentive Payment process This individual will enter the volume information for the Group and this information will appear on each Group member s Confirm Medicaid Eligibility page Each member of the Group will still need to review and sign the Attestation form to ensure that the numbers are correct Group administrators will select the Group user type when they first create a SLR account Group Home Page The SLR Home page for Groups is similar to the home pages for EP and EH users See the EP Home page section for more information about the parts of this page The links in the Header and Footer sections the Reports and Messages sections and the Year tabs are all identical to the EP Home page except the messages will now include Group messages The only visible difference on the page for Group users is the Workflow section though it will still have five steps As with the EP Home page each of these is a link to the page
70. ning for colorectal Process Screening cancer Effective ness CMS126 Use of Percentage of patients 5 64 years of age Clinical Appropriate who were identified as having persistent Process 45 SLR Group Administrator User Guide Medications for asthma and were appropriately prescribed Effective Asthma medication during the measurement period ness CMS127 Pneumonia Percentage of patients 65 years of age and Clinical Vaccination older who have ever received a Process Status for pneumococcal vaccine Effective Older Adults ness CMS131 Diabetes Eye Percentage of patients 18 75 years of age Clinical Exam with diabetes who had a retinal or dilated eye Process exam by an eye care professional during the Effective measurement period or a negative retinal ness exam no evidence of retinopathy in the 12 months prior to the measurement period CMS123 Diabetes Foot Percentage of patients 18 75 years of age Clinical Exam with diabetes who had a foot exam during Process the measurement period Effective ness CMS122 Diabetes Percentage of patients 18 75 years of age Clinical Hemoglobin with diabetes who had hemoglobin A1c gt Process Aic Poor 9 0 during the measurement period Effective Control ness CMS148 Hemoglobin Percentage of patients 5 17 years of age Clinical Aic Test for with an HbAic test during the measurement Process Pediatric period Effective Patients ness CMS
71. ntly of other certified EHR technologies The exchange of information requires that the provider must use the standards of certified EHR technology as specified by the Office of the National Coordinator for Health IT not the capabilities of uncertified or other vendor specific alternative methods for exchanging clinical information Electronic Exchange of Clinical Information A type of provider that includes all organizations receiving grants under Section 330 of the Public Health Service Act Advantages include grant funding enhanced Medicare and Medicaid reimbursement medical malpractice coverage through the Federal Tort Claims Act reduced cost for medications for outpatients etc The purpose of the Health Insurance Portability and Accountability Act is to improve the Medicaid program and the efficiency and effectiveness of the health care system by encouraging the development of a health information system through the establishment of standards and requirements for the electronic transmission of certain health information Health Information Technology HIT refers to the use of technology in managing health information For example the use of electronic health records instead of paper medical records The Health Information Technology for Economic and Clinical Health Act of 2009 HITECH amends the Public Health Service Act by adding a number of funding opportunities to advance health information technology
72. nts must have records in the EHR solution Eligible Professionals who work at multiple locations but don t have certified EHR technology available at all of their locations must have 50 of their total patient encounters at locations where the EHR technology is available 1 Certified EHR Technology 2014 edition EHR certification criteria support revised MU Stage 1 and new Stage 2 requirements and include important updates that set new baselines for interoperability electronic health information exchange and patient engagement EHR technology certified to the 2011 Edition will no longer be acceptable for the purposes of meeting the Certified EHR Technology definition From a regulatory perspective 2011 Edition certifications will expire come the 2014 MU reporting period 2 EHR Certification page The EHR Certification page in the Meaningful Use section is identical to the EHR Certification page in the A U section except that it also contains a Supporting Documentation section This allows the user to attach a file if needed Select the Provider Understands Responsibility checkbox to accept responsibility for finding and entering the correct EHR Certification Number into the previous page A link to the Office of the National Coordinator for Health IT ONC website is provided SLR Group Administrator User Guide 35 EHR Certification Providers must provide information demonstrating that their EHR technology is certified through the Off
73. o save your account If you left a required field blank or entered information incorrectly you will receive an error message 10 Cancel and return to Login link select this button to cancel all the changes and return to the Login page SLR Group Administrator User Guide 15 Create Account Is This You Name Address Create Login Enter the necessary information below and click Create Account Red asterisk indicates a required field User ID Password Confirm Password Select a Challenge Question Select Challenge Question x Your Answer to the Challenge Question Phone 3HE AHHH Hat E mail address name domain com Confirm E mail address name domain com Create Account gt Cancel and return to Login Once you click the Create Account button you will be routed to the final page for creating an account The final Create Account page displays the following 1 Account successfully created display message signifies that you have successfully created your SLR account 2 Continue to Login button opens the Login page SLR Group Administrator User Guide 16 Accepting the End User License Agreement EULA After your first login to the system you will be presented with the End User License Agreement EULA You must read and agree with the EULA in order to continue The End User License Agreement page displays the following 1 Agree with the End User License Agreement check
74. od fields a Numerator text field enter the number of patients with records in the certified EHR technology during the reporting period b Denominator text field enter the total number of patients during the reporting period c Calculate button at least 80 of patients must have records in the certified EHR technology The Numerator will be divided by the Denominator and the percentage is displayed on the page EHR Reporting Period EHR Reporting Period CMS requires that providers meet the following regulations for attesting to Meaningful Use 80 of patients must have records in the certified EHR technology Numerator 800 Denominator 4 900 Ceiculste fy Percentage 80 Numerator number of patients with records in the certified EHR technology during this reporting period Denominator total number of patients during this reporting period Eligible Professionals who work at multiple locations but don t have certified EHR technology available at all of their locations must Have 50 of their total patient encounters at locations where certified EHR technology is available Base all meaningful use measures only on encounters that occurred at locations where certified EHR technology is available a M Edit 1285 SPRING STREET SUITE A GULFPORT MS 39507 0000 100 150 Yes Remove d Add New Location table Eligible Professionals who work at multiple locations but do not have certified EHR technology available at a
75. or the Core and Menu objective you will be required to manually enter and save Meaningful Use Import B MU Import Specification Control Document File Import File Select Submit Please select the Previous Screen button to go back or the Continue button to proceed x Cancel Continue 5 Navigation Menu The left hand Navigation Menu will contain page titles that serve as links associated with the MU pages that must be completed The majority of MU pages are collected in four or five subgroups Clicking the name of a subgroup or clicking the expand icon E will reveal all the pages in the subgroup all of which must SLR Group Administrator User Guide 38 be completed by the user Once all the pages in a navigation group have been completed and all have passed their validation criteria then the subgroup will receive a completed icon Clicking the collapse icon will hide the title of the individual pages in a subgroup 1 About You PY 2 Confirm Medicaid Eligibility E EHR Certification EHR Reporting Period MU Import MU Core Objectives MU Menu Objectives CQM Import CQM Icon Legend amp Complete A Warming Hard Stop 6 Selection Pages and Detail Pages Each group of measures includes a Selection page which provides a place for the user to select or at least access the measures The Menu Objective Selection page allows a user to select Objective measures since a user must s
76. ovider Any individual or organization to which the patient has granted access to their clinical information Examples would include an insurance company that covers the patient an entity facilitating health information exchange among providers or a personal health record vendor identified by the patient A patient would have to affirmatively grant access to these entities 3 Resources identified through logic built into certified EHR technology which evaluates information about the patient and suggests education resources that would be of value to the patient The concept of only permissible prescriptions refers to the current restrictions established by the Department of Justice on electronic prescribing for controlled substances in Schedule II V The substances in Schedule II V can be found at http www deadiversion usdoj gov schedules orangebook e_cs_sched pdf Any prescription not subject to these restrictions would be permissible The language by which the patient prefers to communicate The authorization by a provider to a pharmacist to dispense a drug that the pharmacist would not dispense to the patient without such authorization 3 15 The Office of the National Coordinator for Health Information Technology ONC The Office of the National Coordinator for Health Information Technology United States Department of Health amp Human Services Date accessed November 22 2010 SLR Group Administrator User Gu
77. pe by selecting the Ambulatory or Inpatient buttons below 2 Select the Browse button to view the list of CHPL products To obtain a CMS EHR Certification ID follow the steps outlined below 4 Select vane nrartire tune hv celectina the Ambulatnry ar Innatient hittans helow 4 Save amp Continue button saves the information you have just entered If you have left a required field blank or entered information incorrectly you will receive an error message Once you have successfully saved the information on all pages within the AIU Attestation of EHR the status icon on your home page will change to indicate that your Attestation of EHR section is complete The system will now allow you move onto Step 4 SLR Group Administrator User Guide 34 Meaningful Use Section The goal of Meaningful Use is to improve health care by providing better access to information and providing patient empowerment In order for a healthcare provider to receive an incentive payment they must show Meaningful Use of their EHR by meeting thresholds for certain objectives as established by CMS The following are the three primary components of Meaningful Use 1 Use of certified EHR in a meaningful manner 2 Use of certified EHR technology to enable the electronic exchange of health information to improve quality of healthcare 3 Use of certified EHR technology to submit clinical quality measures into SLR To attest for Meaningful Use MU providers
78. ral Exclusions Program Option MEDICAID Provider Type Nurse_Practitioner State Rejection Reasons Provider Specialty m 3 Payment Information section located on the left of the home page the Payment section will display the following items on the Home page a How your payment is calculated message opens a pop up window that shows your payment for the current year This will appear after you enter information in the Confirm Eligibility section b Payment Calculation message allows you to check on the status of your payment once your attestation has been submitted 4 Reports section Located on the left of the home page the Reports section displays the following items when selected a Reports message you will see the following message when you don t have any data in the system to run a report on Reports will be available once your information is saved b Report Titles the titles of available reports will appear here For example the Registration and Attestation Summary Report link will appear after you have saved at least some information in the SLR Web application Clicking this link opens a pop up window displaying the report in PDF format 5 Messages sections Located to the left side of the home page the Messages section displays the following items a Audit section provides access to Audit messages b Appeals section provides access to Appeals messages c System Messages section provides access to Syst
79. ration Record Data has been received from the CMS Medicaid EHR Incentive Program Registration site View CMS Medicaid EHR Incentive Program Registration Data Vist CMS tm a 2 The more info link of this field will open a help window AIU Method f Adopt Nd 3 Help Text Help text is text that displays on the page Help text instructs you on how to respond to a particular field or it provides some additional information about the field or the page The blue text from the below example Enter phone number without dashes This is help text SLR Group Administrator User Guide 65 SLR Group Administrator User Guide Contact Person Name ao t d Tite y Phone Number 5 m i Enter phone number without dashes Email Address oS neme comain com 66 Definitions This section lists any glossary terms specifically applicable to this document Term Acronym Explanation Expansion Active Medication List A list of medications that a given patient is currently taking Adjustment An official change in the payment amount of a provider s EHR Incentive payment This can be a positive or negative change Admitted to the Emergency There are two methods for calculating ED admissions for the denominators Department for measures associated with Stage 1 of Meaningful Use objectives Eligible hospitals and CAHs must select one of the methods below for calculating ED admissions to be
80. re also acknowledged SLR Group Administrator User Guide 2 Table of Contents Table of Contents Introduction SLR Application Availability Problem Reporting Overview Dates Application Architecture Materials and Preparations Method Login Accessing the SLR SLR login from the Provider Outreach Web portal SLR login directly from the SLR login URL Creating a New SLR Account for Eligible Professionals and Group Representatives Accepting the End User License Agreement EULA Changing Your Password Navigating SLR Hard and Soft Stops Save and Continue Navigation Bar Applying for the Incentive as an Eligible Professional EP Home Page Workflow Section Details Step 1 About You Section Details Step 2 Confirm Medicaid Eligibility Details Step 3 Attestation of EHR Details AIU Method Page EHR Certification Page Meaningful Use Section Step 4 Review and Sign Attestation Step 5 Send Year X Attestation Details Applying for the Incentive as a Group Administrator Group Home Page Workflow Section Details Step 1 About Your Group Section Details Step 2 Confirm Group Medicaid Eligibility Step 3 Group Certified EHR Information Step 4 Manage Providers in Your Group SLR Group Administrator User Guide 11 13 17 18 20 20 20 20 22 22 24 24 28 32 33 34 35 53 53 55 55 55 56 57 57 58 Step 5 Enter Data for Providers Year Accessing Reports Reports for Eligible Professionals Viewing Payment Status Paymen
81. re screened for tobacco use tion Public Screening one or more times within 24 months AND Health Tobacco Use who received cessation counseling Screening and intervention if identified as a tobacco user Cessation Intervention CMS166 Use of Imaging Percentage of patients 18 50 years of age Efficient Studies for Low with a diagnosis of low back pain who did not Use of Back Pain have an imaging study plain X ray MRI CT Healthcare scan within 28 days of the diagnosis Resources CMS2 Preventive Percentage of patients aged 12 years and Population Care and older screened for clinical depression on the Public Screening date of the encounter using an age Health Screening for appropriate standardized depression Clinical screening tool AND if positive a follow up Depression plan is documented on the date of the and Follow Up positive screen Plan CMS68 _ Documentation Percentage of specified visits for patients Patient of Current aged 18 years and older for which the Safety Medications in eligible professional attests to documenting a the Medical list of current medications to the best of Record his her knowledge and ability This list must include ALL prescriptions over the counters herbals and vitamin mineral dietary nutritional supplements AND must contain the medications name dosage frequency and route of administration CMS69 Preventive Percentage of patients aged 18 years and Popula Care and older wi
82. roup Administrator User Guide 58 Is this the Provider you want to add x No GoBack Yes Add to Group 2 Is this the provider you want to add window this displays the identification numbers name address and Specialty Codes of the provider found using the query fields This additional information helps you to identify the correct medical professional to add to your Group Note You can add providers to the Group but cannot remove providers Be very careful about those providers that you add 3 No Go back button click this button to close the window The professional will not be added to the Group 4 Yes Add to Group button click this button to add the professional to the Group If the provider is found but has opted to use his or her own volume numbers rather than those of a Group the pop up window displays a message that the provider has opted out from Groups 5 List of Providers table displays all the providers added your Group and is sorted alphabetically by last name Each provider s name identification numbers address and Specialty or Taxonomy codes are listed in the table The table also indicates whether the provider has been added to more than one Group Step 5 Enter Data for Providers Year Clicking the Enter Data on Behalf of Your Providers link on the Group Home page or in the Navigation Menu opens Step 5 of the process This page allows you to access the EP pages of the members of your Gro
83. rovider s use of computer assistance to directly enter Order Entry CPOE medication orders from a computer or mobile device The order is also documented or captured in a digital structured and computable format for use in improving safety and organization Ot See Computerized Provider Order Entry Diagnostic Test Results All data needed to diagnose and treat disease Examples include but are not limited to blood tests microbiology urinalysis pathology tests radiology cardiac imaging nuclear medicine tests and pulmonary function tests Different Legal Entities A separate legal entity is an entity that has its own separate legal existence Indications that two entities are legally separate would include 1 they are each separately incorporated 2 they have separate Boards of Directors and 3 neither entity is owned or controlled by the other Discharge Instructions Any directions that the patient must follow after discharge to attend to any residual conditions that need to be addressed personally by the patient home care attendants and other clinicians on an outpatient basis Distinct Certified EHR Each instance of certified EHR technology must be able to be certified and Technology operate independently from all the others in order to be distinct Separate instances of certified EHR technology that must link to a common database in order to gain certification would not be considered distinct However instanc
84. rrect login information before the system locks your account If that happens call the Help Desk for assistance Throughout the SLR application red asterisks display on various fields This symbol indicates that this field is required to be completed in order to continue through the application The Login page displays the following 1 User ID field enter your User ID Password field enter your password Login button verifies the User ID and password you entered and opens the End User License Agreement EULA 4 Forgot User ID link selecting this will open a Forgot User ID pop up asking you for your National Provider Identifier NPI and Tax Identification Number TIN as well as the answer to the Challenge Question you selected when you first created the account Once you have entered those correctly the system will email the User ID to the email address entered when you created your account SLR Group Administrator User Guide 11 Forgot User ID Identify Yourself Select ser role for which you registered then enter the appropriate IDs and click Continue Red asterisk indicates required fields What is your role Select a role NPI TIN Continue gt Cancel and return to Login 5 Forgot Password link select when you have forgotten your password The system will ask you for your User ID as well as the answer to the Challenge Question you picked when creating your account Once you have ent
85. rrespond to the pages in the group component amp 1 About Your Group P 2 Confirm Group Medicaid Eligibility amp 3 Group Certified EHR Technology information 4 Manage Providers in Your Group 5 Enter Data on Behalf of Your Providers Step 1 About Your Group Section Details Clicking the About Your Group link on the Group Home page opens the About Your Group page allowing you to provide contact information The contact information is especially important as one of the primary reasons to have a Group user is to provide a single point of contact for the Group to State auditors that are reviewing the SLR submissions By default this information will be the same as the user registered in the system 1 About Your Group Contact Person 4 Enter your contact information below Red asterisk indicates a required field Contact Person Name oe d Phone Number lt a Ente je numbe e Email Address 2 name 1 Name text field enter your name 2 Phone Number text field enter your phone number Initially it defaults to the phone number that you entered while creating your User Account a 9999999999 no spaces dashes parentheses shows you how the system would like you to enter your phone number 3 Email Address text field enter your email address Initially it defaults to the email address that you entered while creating User Account b name domain com displays the correct format for your email addres
86. rtification Number CCN is the hospital s identification number that is link to its Medicare provider agreement The CCN is used for CMS certification and also for submitted and reviewing the hospital s cost reports Centers for Medicare amp Medicaid Services CMS Centers for Medicare amp Medicaid services United States Department of Health amp Human Services Date accessed November 22 2010 3 HITECH Attestation Mockups EP and HITECH Attestation Mockups EH Version 9 CMS Centers for Medicare amp Medicaid services United States Department of Health amp Human Services Date published 3 8 2011 4 Frequently Asked Questions about Accrediting Hospitals in Accordance with their CMS Certification Number CCN The Joint Commission Article date July 15 2010 Date accessed November 22 2010 SLR Group Administrator User Guide 68 Term Acronym Explanation Expansion CMS Medicaid EHR The national d that supports the administration and incentive payment Incentive Program disbursements of Medicare and Medicaid programs to medical Registration site professionals hospitals and other organizations Computerized Physician Computerized Physician Order Entry CPOE refers to any system in which Order Entry CPOE Clinicians directly enter medication orders and or tests and procedures into a computer system which then transmits the order directly to the pharmacy Computerized Provider CPOE entails the p
87. s 4 Save amp Continue button saves the information you have just entered If you have left a required field blank or entered information incorrectly you will receive a system message Once all required fields are completed this section will be marked as complete SLR Group Administrator User Guide 56 5 Cancel and Lose About Your Group changes link clears the page of any information you have just entered Step 2 Confirm Group Medicaid Eligibility The Confirm Group Eligibility page is identical to the associated page for EPs except that it has an additional section at the top the Group Medicaid Volumes section 1 See Section 3 6 4 Step 2 Confirm Medicaid Eligibility above for a complete description of the rest of the fields on this page 2 The Group Medicaid Volumes section allows to user to select whether to use Group Medicaid volumes for the entire Group Group Medicaid Volumes Do you want to use Group Medicaid volumes for all providers associated with the group O O The system will move you onto Step 3 Group Certified EHR Information and the status icon on your home page will change to indicate that your eligibility information is complete Step 3 Group Certified EHR Information Clicking the Group Certified EHR Information link on the Group Home page directs you to Step 3 of the process This page allows you to enter your practice s EHR technology information 1 Do you wish to use Group Certified EHR Te
88. s message appears if your data has not been received by the SLR b Data has been received from the CMS Medicaid EHR Incentive Program Registration site message this message appears if the SLR has received your CMS data c View CMS Medicaid EHR Incentive Program Registration Data link this link is visible if your CMS data has been received Clicking the link opens a pop up window that displays the CMS data If you need to make a change to your CMS data you must make updates on the CMS site You cannot make changes to your CMS data through SLR and it takes between two and three days for changes at the CMS level to be applied to SLR d Visit CMS website link opens the CMS website The link is visible whether or not your data has been received 1 About You In addition to registration information you provided on the CMS Medicaid EHR Incentive Program Registration site the State of that you provide additional information to be used to help determine your eligibility to participate in the Montana Medicaid Incentive Program Z Red asterisk indicates a required field CMS Medicaid EHR Incentive Program Registration Record Data has been received from the CMS Medicaid EHR Incentive Program Registration site View CMS Medicaid EHR Incentive Program Registration Data Visit CMS website a 2 Print Registration Information link opens a PDF that contains contact information filing information and license information 3 Att
89. s radio button opens the Group Practice Eligibility gt gt Opt Out window SLR Group Administrator User Guide 28 Group Practice Eligibility Opt Out x Are you sure you want to opt out because you elect to use volumes from your individual practice If you proceed by clicking OK you will be unable to utilize the group clinic volumes You may contact the ACS Help Desk at 866 879 0109 to discuss the implications Clicking Cancel will reset your choice without saving any data f lam opting out of using any group clinic volumes and am electing to use my individual patient volumes radio button this field appears if the No radio button in the Group Practice Eligibility Information field is selected Users select this button to use their patient volumes with the group practice rather than the patient numbers of the group to which they are affiliated This will generally happen if overall the group does not qualify for an EHR Incentive payment by achieving the necessary 30 But one or two members of the group may still qualify using their own volume Clicking this radio button opens the Group Practice Eligibility gt gt Opt Out window 1 Reason for Opting Out field this time the window contains this field Enter the reason you have decided not to use the group volume and then click the OK button Group Practice Eligibility Opt Out x Are you sure you want to opt out of any group clinic volumes If you proceed by clic
90. se number b Montana Professional License Number text field enter the professional license number assigned by the Montana licensing board This can be between 1 and 9 digits c Licensing Board Name pull down menu choose your licensing board from a drop down menu d Regional Extension Center REC Affiliation pull down menu select MT REC if you are affiliated with the REC License Information AS Your License Information is complete Do you practice in a Tribal Health Program or other oO Federal Clinic withouta Yes No Montana License S Montana Professional License oS Number Licensing Board Name Montana Board of Medical Examiners Regional Extension Center MT REC a aS REC Affiliation e Payee Medicaid ID pull down menu if the user s designated payee entered when registering with CNS has more than one Medicaid ID you must select the ID to receive payment SLR Group Administrator User Guide 26 Payee Medicaid ID If your designated payee has more than one Medicaid ID you must select the ID to receive payment 5 Contact Person section This allows you to enter an additional contact besides the one listed as the Eligible Professional i Contact Person Name text field enter the name of the contact ii Title text field enter the title of the individual iii Phone Number text field enter the phone number as ten digits with no spaces dashes or parentheses iv Email A
91. selected Alternate CQM SLR Group Administrator User Guide 41 Users are required to select three Additional CQMs from among the options on the Stage 1 Additional CQM Selection page Clicking the Save amp Continue button will open the Detail page of the first selected Additional CQM In 2014 certain Core and Menu objectives have been removed or combined and providers will no longer count measure exclusions toward meeting menu objectives Stage 1 EPs EHs and CAHs now need to provide more than 50 of unique patients with the ability to access their health information online to meet the new Stage 1 Core measure the View Download Transmit to Third Party objective 13 Stage 2 CQM In 2014 CQMs will change to a new Stage 2 list EPs must report on a total of nine measures that cover at least three of the National Quality Strategy Domains and should select CQMs that best apply to their scope of practice and or unique patient population If the EP s certified EHR software does not contain patient data for at least 9 CQMs covering in at least 3 domains then the EP must report the CQMs for which there is patient data The EP would place a zero in the denominator of any of the remaining required CQMs Clinical Quality Measures EPs must report on a total of nine 9 Clinical Quality Measures that cover at least three 3 of the National Quality Strategy domains EPs should select the CQMs that best apply to their scope of practice and or
92. ss Practice City State and Zip Code display fields the City State and Zip Code of your practice Affiliated with Group Practice Name display field If you are affiliated with a Group practice your Group s name will appear Last Updated display field displays the last person who updated your account and the date it was updated 2 Next Steps section Located to the left of the page the Next Steps section displays messages a Begin Continue Complete your Year X submission message displays the year of attestation you are currently completing b Section link communicates the next page in the process that must be completed c CMS Message display field this will display Data has has not been received SLR Group Administrator User Guide from the CMS Medicaid EHR Incentive Program Registration site which indicates whether the SLR application has received data from the CMS 22 i View CMS Medicaid EHR Incentive Program Registration Data link opens a pop up window that displays your CMS record CMS Medicaid EHR Incentive Program Registration Record x General information Last Updated First Name Date 9 2 2011 Middle Name Last Name Suffix Address Line 1 Address Line 2 as City Personal NPI State Personal TIN Zip Personal TIN Type Phone Number Payee NPI Phone Extension Payee TIN E Mail Address Payee TIN Type EIN Confirmation Number EHR Cert ID 20000002GKUREAA Exclusions Program Participation Year 1 Fede
93. ssionals attesting to Meaningful Use for the first time need to report Meaningful Use for a 90 day period in the current payment calendar year In this case the earliest date an Eligible Professional can submit an attestation for Meaningful Use for calendar year 2012 is April 1 2012 Please return to the site on April 1 2012 to complete your Meaningful Use attestation AIU Method Page Once the Attest to Adopt Implement Upgrade button is selected two new navigation options appear in the Navigation Menu AIU Method and EHR Certification The AIU Method page is opened This page allows you to choose the method of your AIU attestation and provide any supporting details for that choice 1 More info link opens a PDF document titled Attestation of AIU that explains how documentation would be attached for the selected attestation method AIU Method pull down menu select Adopt Implement or Upgrade from the menu to best describe your EHR Technology use at this point more info link opens a pop up window explaining the type of documentation that needs to be attached for the selected attestation method Please describe briefly how you meet text area allows you to describe how you meet the criteria for the AIU method selected Attach Documentation section Missouri requires a fully executed contract with an EHR Vendor to be attached to the page An Invoice Receipt or Vendor Letter can also be added Save amp Continue bu
94. t CQM Import File Format PQRI XML Format File Select Submit M Please select the Previous Screen button to go back or the Continue button to proceed x Cancel Continue 11 Core Clinical Quality Measures Clinical Quality Measures or CQMs capture information about patient treatments and diagnoses instead of information about the number of patients in the EHR There are no passing percentages as these pages are simply intended to capture information about patients 12 Stage 1 CQMS Stage 1 Core CQMs are all required If your practice has seen no patients to which one of these CQMs would apply you will enter 0 in the Denominator field of that page s Detail page For example one CQM has 2 lines of Population Criteria each line having a Numerator Denominator and Exclusion field NQF 0421 POR 128 Title Adult Weight Screening and Follow up De If the user entered a zero in either of these Denominators the Alternate CQM Selection link will appear in the Navigation Menu and one of the three Alternate CQMs is now required If zero was entered into Denominator fields of three Core CQM pages then all three Alternate CQMs would be required The Alternate CQM Selection page allows a user to select between one and three CQMs depending on how many Core CQMs had a zero in a Denominator field Clicking the Save amp Continue button will open the Detail page entered of the first
95. t Calculations Payment Information and Calculations for Eligible Professionals Appeals Adjustments and Recoupments Appeals Adjustments Recoupments Attaching Files The Attach Documentation Section Timing Out Troubleshooting Accessing Help Help Text Displays Definitions SLR Group Administrator User Guide 59 61 61 62 62 62 62 62 62 63 63 64 65 65 65 67 Introduction The overall goal of the User Manual is to help guide medical professionals through the process of completing their State s application for the Centers for Medicare amp Medicaid Management s CMS s EHR Incentive Payment This application is submitted through the State Level Registry a web tool designed to capture all information needed for the approval of the EHR payment and to submit the application to your State Users are called Eligible Professionals EPs because medical personnel other than physicians can also apply for the incentive payment Nurse Practitioners are one example SLR Application Availability The SLR application is on the Web and is available 24 hours a day 7 days a week and is accessible from the internet Problem Reporting For general Help all SLR web pages have a Help Link that opens up a copy of this User Manual For SLR technical support you can contact the ACS Help Desk designated to support the SLR Phone 866 879 0109 Email SLRHelpdesk acs inc com Fro questions about the Montana EHR incentive pay
96. t Ventricular beta blocker therapy either within a 12 month Systolic period when seen in the outpatient setting Dysfunction OR at each hospital discharge LVSD CMS143 Primary Open Percentage of patients aged 18 years and Clinical Angle older with a diagnosis of POAG who have Process Glaucoma had an optic nerve head evaluation during Effective POAG Optic one or more office visits within 12 months ness Nerve Evaluation CMS167 Diabetic Percentage of patients aged 18 years and Clinical Retinopathy older with a diagnosis of diabetic retinopathy Process Documentation who had a dilated macular or fundus exam Effective of Presence or performed which included documentation of ness Absence of the level of severity of retinopathy and Macular presence or absence of macular edema Edema and during one or more office visits within 12 Level of months Severity of Retinopathy CMS142 Diabetic Percentage of patients aged 18 years and Clinical Retinopathy older with a diagnosis of diabetic retinopathy Process Communicatio who had a dilated macular or fundus exam Effective n with the performed with documented communication ness SLR Group Administrator User Guide 47 Physician to the physician who manages the ongoing Managing care of the patient with diabetes mellitus Ongoing regarding the findings of the macular or Diabetes Care fundus exam at least once within 12 months CMS161 A
97. t a jump start Click Here section clicking this link opens up a new window and will guide you through the process of gathering information to complete the SLR the link to create an account c Regional Extension Centers REC section clicking a link in this section opens up a new window and displays the REC website a Stealth Sechnotogy Sewtces REGIONAL EXTENSION CENTER adnagion of MOUNTAIN PACIFIC QUALITY HEALTH waw hisrec com 06 457 5888 4 Important Web Resources section clicking a link in this section opens up a new window and displays the associated website 5 Footer section Located at the bottom of the page the footer displays the following items a Privacy link opens the approved Statewide Policy for Internet Privacy and Security in a new window b Terms of Use link Clicking this link opens a new window with a Terms of Use policy displayed c Accessibility link Clicking this link opens a new window with the website s Accessibility policy displayed d ACS Xerox copyright this is ACS s copyright symbol and text SLR Group Administrator User Guide 9 MONTANA Healthy People Healthy Commmities Depomed a Meats ttt A Nomas Menten Deadlines for Calendar Year 2012 Montana Medicaid EHR Incentive Payment Applications Registration for Montana Eligible Professionals EP and Eligible Hospitals EH began on November 7th 2011 The first year payment is based on the EP EH attest
98. t of the home page the Payment section will display the following item on the Home page 1 How your payment is calculated message opens a pop up window that shows your payment for the current year Any Recoupment or Adjustment information is also displayed here 2 Payment Status message check on the status of your payment in this area Appeals Adjustments and Recoupments Appeals Providers are able to appeal a rejection of their Attestation The rules and details are specified by the State of Montana and will follow guidelines established by CMS All communications and the progression of each Appeal will be handled by State representatives Adjustments An Adjustment in SLR is an official change in the payment amount of a provider s EHR Incentive payment For EPs an Adjustment is more likely for Pediatricians than other Provider Types because they can still qualify for an EHR Incentive payment at a 20 Medicaid volume If a Pediatrician s percentage changes because of an change in claims an entry mistake or an Audit this might mean a higher or lower payment As with Appeals State representatives will handle the communication with providers regarding all Adjustments Recoupments A Recoupment is a return to the State of the full amount paid to the provider for a Payment Year This will usually be the result of Audit showing a mistake in the Medicaid claims percentage As with As with Appeals and Adjustments State represent
99. te or not W indicates that the step is complete indicates that the step has been started but not finished indicates that the step has not been started Eligibility column contains a status icon Attestation column contains a status icon Signed amp Attached column contains a status icon Submitted column contains a status icon Actions pull down menu allows the user to open the associated page and enter data into SLR for that user Select an option for the menu such as About You Eligibility or Attestation and the corresponding page of that user will open Entering on behalf of Back to Provider List Contact Person Attach Documentation When opened the SLR page of your Group s provider will be topped by a special header identifying the provider you are entering information for such as in the example above The header section also has a lt Back to Provider list button which returns you to the Group Administrator Step 5 page SLR Group Administrator User Guide 60 Accessing Reports Reports for Eligible Professionals Located to the left of the page the Reports section displays the following items 1 Reports message the following message appears if you don t have any data in the system to run a report Reports will be available once your information is saved 2 Provider SLR Application Information link once some information has been saved to the SLR web application this link appears
100. th a calculated BMI in the past six tion Public Screening months or during the current reporting period Health Body Mass documented in the medical record AND if the Index most recent BMI is outside of normal BMI parameters a follow up plan is documented Screening and within the past six months or during the Follow Up current reporting period Normal Parameters e Age 65 years and older BMI 2 23 and lt 30 e Age 18 64 years BMI 2 18 5 and lt SLR Group Administrator User Guide 43 25 CMS55 Closing the Percentage of patients with referrals Care referral loop regardless of age for which the referring Coordina receipt of provider receives a report from the provider tion specialist to whom the patient was referred report CMS90 Functional Percentage of patients aged 65 years and Patient status older with heart failure who completed initial and assessment for and follow up patient reported functional Family complex status assessments Engage chronic ment conditions Pediatric Recommended Measures CMS146 Appropriate Percentage of children 2 18 years of age Efficient Testing for who were diagnosed with pharyngitis Use of Children with ordered an antibiotic and received a group A Healthcare Pharyngitis streptococcus strep test for the episode Resources CMS155 Use of Imaging Percentage of patients 18 50 years of age Efficient Studies for Low with a diagnosis
101. the EH or their respective administrative staffs are unavailable The Centers for Medicare and Medicaid Services CMS is a United States Federal Agency which administers Medicare Medicaid and the Children s Health Insurance Program CHIP HIT functionality that builds upon the foundation of an EHR to provide persons involved in care decisions with general and person specific information intelligently filtered and organized at point of care to enhance health and health care An after visit summary that provides a patient with relevant and actionable information and instructions containing the patient name provider s office contact information date and location of visit an updated medication list updated vitals reason s for visit procedures and other instructions based on clinical discussions that took place during the office visit any updates to a problem list immunizations or medications administered during visit summary of topics covered considered during visit time and location of next appointment testing if scheduled or a recommended appointment time if not scheduled list of other appointments and tests that the patient needs to schedule with contact information recommended patient decision aids laboratory and other diagnostic test orders test laboratory results if received before 24 hours after visit and symptoms A number assigned to hospitals by the Centers of Medicare and Medicaid Services the CMS Ce
102. tion Program Year Program Year Select a Program Year v a Save and Continue SLR Group Administrator User Guide 6 Application Architecture The SLR Web application features the following e Compliance with Section 508 accessibility guidelines e Accessibility from the internet ACS has made every effort to make this site accessible to people with disabilities In the event you experience difficulty accessing this site with assistive devices please contact our Help Desk at 866 879 0109 for assistance in obtaining the information you need State of Montana accessibility standards are available for review e Secure protected page access Materials and Preparations Materials the user will need to use the software e Computers with access to the web browser e Software Adobe Acrobat Reader installed on your machine to view PDF files e Pop up Blocker browser feature should be set to Off to receive the Pop up window features e Manuals and or FAQ s that are available for distribution Also note that this application is compatible with Microsoft Internet Explorer V7 0 and above only SLR Group Administrator User Guide 7 Method Login Accessing the SLR The SLR is a web based application accessible from the internet via the Provider Outreach Web portal or directly from a login URL 1 Open Microsoft Internet Explorer to access the Web 2 Type your State s URL in the address field and press t
103. tive Percentage of patients aged 20 through 79 Clinical Care and years who had a fasting LDL C test Process Screening performed and whose risk stratified fasting Effective Risk Stratified LDL C is at or below the recommended LDL ness Cholesterol C goal Fasting Low Density Lipoprotein LDL C CMS149 Dementia Percentage of patients regardless of age Clinical Cognitive with a diagnosis of dementia for whom an Process Assessment assessment of cognition is performed and Effective the results reviewed at least once within a 12 ness month period CMS65 Hypertension Percentage of patients aged 18 85 years of Clinical Improvement in age with a diagnosis of hypertension whose Process blood pressure blood pressure improved during the Effective measurement period ness Patient Safety Domain CMS156 Use of High Percentage of patients 66 years of age and Patient Risk older who were ordered high risk Safety Medications in medications Two rates are reported the Elderly a Percentage of patients who were ordered at least one high risk medication b Percentage of patients who were ordered at least two different high risk medications CMS139 Falls Percentage of patients 65 years of age and Patient Screening for older who were screened for future fall risk Safety Future Fall during the measurement period Risk CMS68 Documentation Percentage of visits for patients aged 18 Patient of Current years and older for wh
104. tton selecting this will open the EHR Certification page after SLR ensures that all fields on this page are populated SLR Group Administrator User Guide 33 EHR Certification Page This page allows you to identify your EHR Technology and attach supporting documentation It appears for both AIU and MU 1 Understanding checkbox signifies that you agree with the statement of understanding next to the checkbox When you check this box additional fields display If you do not check this box the system will not allow you to continue a I understand that it is my responsibility as the provider to ensure This is a statement of understanding as to your responsibility to demonstrate that your EHR technology is certified through the ONC When you check the box before this statement you will be required to complete the other field on the page If you do not check the box before this statement the system will not allow you to continue b ONC public web service link opens the Office of the National Coordinator for Health Information Technology s Certified Health IT Product List site 2 The Your EHR Certification Information section When you select the EHR Certification option in the Navigation Bar and are a member of a Group the CMS EHR Certification ID field may already be populated containing a certification number entered by your Group s contact Otherwise you will have to enter the correct number 3 This section also inc
105. up and view add or edit the data for them Each provider that was added using the Manage Providers in Your Group page will appear in the table on this page 5 Enter Data on Behalf of Your Providers OFA p Not started 0 1 mit ad 0 Signed Subr B icine Provider Pymt Multiple About Signed amp Name NPI TIN Yr Groups Elected You Eligibility Attestation Attached Submitted Actions 1 No Yes v 1 Manage Providers button clicking this will open the Manage Providers in Your Group page which is used to add providers to your Group 2 Of n Providers Not started n In progress n Completed n Signed amp Attached n Submitted n message next to the Manage Providers bution is a SLR Group Administrator User Guide 59 status line that provides a running count of the providers in your Group and their progress in each stage of the process 3 Provider Action List table displays all the members of the providers in the Group each provider will have the following columns referencing their data a b c d Provider Name column displays the name of the provider NPI column the provider s NPI information TIN column the provider s TIN information Pymet Yr column the Payment Year to which the provider is attesting Elected column indicates whether the provider has joined your Group or not About You column contains a status icon that indicates whether this section for a provider is comple
106. whether you have met the requirements for eligibility i Yes displays if the result of the formula you selected meets the following criteria e 220 for Pediatricians e 230 for all other Provider Types 31 SLR Group Administrator User Guide ji No you may wish to adjust your reporting period displays if the result of the formula you selected does not meet the criteria listed above t Attach Documentation Section documents such as a Practice Management report could be attached using this tool u Save amp Continue button saves the information you have just entered If you have left a required field blank or entered information incorrectly you will receive an error message If you do not meet the requirements you will not be able to proceed v Cancel and lose Medicaid Eligibility changes link clears the page of any information you have just entered Save amp Continue A Cancel and lose Medicaid Eligibility changes Once the About You and Eligibility pages are successfully saved the system will move to Step 3 Attestation of EHR The status icon on your home page will change to indicate that your eligibility information is complete Step 3 Attestation of EHR Details EPs may either attest that they have adopted implemented or upgraded EHR software or that they are actively using it in meaningful ways AIU can only be selected in the first year and it is a much easier attestation Clicking the Attestation of EHR l
107. y a provider more than once during the EHR reporting period then for purposes of measurement that patient is only counted once in the denominator for the measure All the measures relying on the term unique patient relate to what is contained in the patient s medical record Not all of this information will need to be updated or even be needed by the provider at every patient encounter This is especially true for patients whose encounter frequency is such that they would see the same provider multiple times in the same EHR reporting period The term up to date means the list is populated with the most recent diagnosis known by the provider This knowledge could be ascertained from previous records transfer of information from other providers diagnosis by the provider or querying the patient 74
108. y is such that they would see the same provider multiple times in the same EHR reporting period American Reinvestment The American Reinvestment and Recovery Act of 2009 is an economic and Recovery Act of 2009 stimulus package enacted by the 111th United States Congress in ARRA February 2009 Part of the act included money for health information technology HIT investments and payments 1 American Recovery and Reinvestment Act of 2009 Wikipedia The Free Encyclopedia Wikimedia Foundation Inc Last modified November 18 2010 Date accessed November 22 2010 SLR Group Administrator User Guide 67 Term Acronym Appeal Appropriate Technical Capabilities Business Days Centers for Medicare and Medicaid Services CMS Clinical Decision Support Clinical Summary CMS Certification Number CCN Explanation Expansion A petition by a provider to change a decision made by a State user or Auditor The rules and details follow guidelines established by CMS and are enforced at the State level A technical capability would be appropriate if it protected the electronic health information created or maintained by the certified EHR technology All of these capabilities could be part of the certified EHR technology or outside systems and programs that support the privacy and security of certified EHR technology Business days are defined as Monday through Friday excluding Federal or State holidays on which
109. your registration section is complete SLR Group Administrator User Guide 27 Step 2 Confirm Medicaid Eligibility Details Clicking the Confirm Eligibility link on the EP Home page opens the Confirm Medicaid Eligibility page which allows you to enter specific practice information This information is then used in the calculation that determines your Medicaid eligibility for the Provider Incentive program The Confirm Medicaid Eligibility page displays the following 1 lt Back to Dashboard link clicking this link will return you to the home page 2 Print Registration Attestation link opens a PDF document that contains all the information captured by SLR so far in the process 3 More Info link opens a PDF file that provides more detailed information about entering your Medicaid eligibility for the provider incentive program 4 Group Practice Eligibility section This section will appear only if you have been added to a Group Group members have a single point of contact for the SLR process and have their Eligibility information added by a Group Administrator rather than entering it themselves Group Practice Eligibility o wish to change my Group Association Do you want to use group practice eligibility information more info an No Ye practice in more than one group clinic and am electing to use volumes from group a Iwish to change my Group Association checkbox this allows you to select a different Group

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