As you begin the Physician Quality Reporting Initiative (PQRI) process, we strongly recommend that you take a moment to read through this roadmap. The PQRI roadmap is provided in an effort to enhance your facility and comfort level in completing the PQRI Module.
- It's highly recommended that you print out a copy of this roadmap for quick reference.
- Login to the Physician Portfolio using your ABFM ID and password.
- Follow the PQRI link in the Physician Portfolio to the Track Your Progress page and from there to the Part IV Modules page where you can choose to begin the PQRI module.
- On the PQRI start page, you will be given a unique PQRI ID that will enable you or your staff to access the module while bypassing access to your Physician Portfolio. Your PQRI ID will be operational for the remainder of your MC-FP cycle. However, as soon as your data has been successfully transmitted to the Centers for Medicare and Medicaid Services (CMS) AND you have decided not to complete the quality improvement and post intervention data collection parts of the module for Part IV MC-FP credit, the ABFM will no longer retain any link to the PQRI ID for reasons related to privacy.
- If you indicate that you wish to use the PQRI module for MC-FP Part IV credit, the PQRI ID will remain operational until you successfully complete the second part of the module. Once it has been successfully completed, the ABFM will no longer retain any link to PQRI ID for reasons related to privacy. If you wish to use the ID beyond this time, you must retain the number. ABFM will not be able to provide your PQRI ID information after you have completed the module.
- To begin the PQRI process, read the introduction and then complete the Registry Terms and Conditions of Use page. As a part of the Registry Terms and Conditions of Use, we ask that you provide the NPI and TIN that you, or that your medical group uses for you, to bill Medicare. Next, download and print out at least 30 copies of the PQRI Template. You may now log out of the PQRI area of the ABFM website. You will be required to save all copies of the PQRI Templates as these will provide the only link between the data that you have entered and the patients you have seen, which must be verified if you are randomly chosen to be audited.
- Gather data on 30 unique, separate and distinct patients using the PQRI Template that you have downloaded. The date of service for these patients must be between January 1st and December 31st. Not all of the patients must be Medicare Part B beneficiaries, but your sample must include AT LEAST two (2) of these patients. You must complete a template for each unique patient with the diagnosis of Type 1 or Type 2 Diabetes Mellitus. If the patients are not unique, separate and distinct, CMS will consider your data incomplete, and you will not receive the bonus.
- Once you have gathered data on 30 unique, separate and distinct patients and you are certain that you have at least 2 Medicare Part B patients in your sample (if you do not have at least 2 Medicare Part B beneficiaries, keep collecting data on additional patients until you do), return to the PQRI area of the ABFM website and enter the data from the PQRI Templates. You may allow your staff to do this by providing them with your PQRI ID, which allows them access to the PQRI module but not to any of the information in your Physician Portfolio.
- Once you have entered data for all of your patients, you will receive a report providing feedback on your performance on each of the PQRI measures. This report will include comparisons to your peers’ performance. NOTE: If one of your staff is entering your data for you, you may want them to print out your report for you so that you may view it at a later date.
You have now completed the reporting requirement for PQRI. The ABFM will transmit your data to CMS at the appropriate time. Be certain to save the data collection templates! Approximately 3% of the registry’s participants will be randomly selected for audit, so it is important that you maintain the templates that you have completed. You will be sending the ABFM de-identified data, so these templates provide the only link between the data you send to us and the patients you have seen, which must be verified if you are selected for audit.
*** At this point, you will be able to continue the module to satisfy your Part IV MC-FP requirement if you choose to do so. All the steps remaining are related to completing the module for Part IV MC-FP credit, and are not required if you are only completing the PQRI module for purposes of reporting your data to CMS. ***