Performance Year 2018 - MicroMD Manuals/UDS...MicroMD PM UDS Reporting Guide: Performance Year 2018...

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Performance Year 2018

Transcript of Performance Year 2018 - MicroMD Manuals/UDS...MicroMD PM UDS Reporting Guide: Performance Year 2018...

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Performance Year 2018

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Trademarks Because of the nature of the material, numerous hardware and software products are mentioned by their

trade names in this publication. All product names referenced herein are trademarks of their respective

companies. The marks MICROMD, HENRY SCHEIN, and the HENRY SCHEIN LOGO are registered

trademarks of HS TM, LLC, a subsidiary of Henry Schein, Inc.

Copyright

This document is covered by the terms and conditions of the license agreement and/or the non-discloser

agreement and may only be reproduced if allowed by the terms of that agreement or with written consent

of Henry Schein, Inc.

Last updated: November 19, 2018

MicroMD PM UDS Reporting Guide: Performance Year 2018

© 2018 Henry Schein Medical Systems, Inc. All rights reserved.

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Table of Contents

PrefaceHow This Guide is Organized........................................................................................................................... .iConventions Used in This Guide..................................................................................................................... .i

Cross-References........................................................................................................................................ .iText You Type Using the Keyboard......................................................................................................... .iKeys You Press and Buttons You Click ................................................................................................... .iDialog Box, Application Window Titles, and Field Names ................................................................. .iWarnings, Notes and Tips ........................................................................................................................ .ii

Chapter 1: Overview of MicroMD PM and UDS ReportsOverview ........................................................................................................................................................... 1.1Reporting Dates............................................................................................................................................... 1.1Terminology..................................................................................................................................................... 1.1Changes for Performance Year 2018........................................................................................................... 1.2

Chapter 2: Service Area ReportIn This Chapter ................................................................................................................................................ 2.1Report Options ................................................................................................................................................ 2.1ZIP Code Data.................................................................................................................................................. 2.1

Chapter 3: Patient Profile (Tables 3A, 3B, and 4)In This Chapter ................................................................................................................................................ 3.1Report Options ................................................................................................................................................ 3.1Table 3a – Universal Patients by Age and by Sex Assigned at Birth ..................................................... 3.2Table 3b – Demographic Characteristics................................................................................................... 3.3

Lines 1 through 8: Patients by Race..................................................................................................... 3.3Line 12: Patients by Language .............................................................................................................. 3.4Lines 13 through 19: Patients by Sexual Orientation ....................................................................... 3.4Lines 20 through 26: Patients by Gender Identity............................................................................. 3.5

Table 4 – Selected Patient Characteristics ................................................................................................ 3.5Lines 1 through 6: Income as Percent of Poverty Level ................................................................... 3.5Lines 7 through 12: Principal Third-Party Medical Insurance Source........................................... 3.6Lines 13a through 13c: Managed Care Utilization ............................................................................ 3.6Lines 14 through 26: Characteristics – Special Populations........................................................... 3.7

Chapter 4: Staffing and Utilization (Table 5)In This Chapter ................................................................................................................................................ 4.1Prerequisites for Information in the Report .............................................................................................. 4.1Report Options ................................................................................................................................................ 4.1Columns on Table 5 ....................................................................................................................................... 4.2

Column A: FTEs........................................................................................................................................ 4.2Column B: Clinic Visits ............................................................................................................................ 4.2Column C: Patients ................................................................................................................................. 4.3

Chapter 5: Selected Diagnoses and Services Rendered (Table 6a)In This Chapter ................................................................................................................................................ 5.1Report Options ................................................................................................................................................ 5.1

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Lines 1 through 20d: Diagnostic Category ................................................................................................. 5.2Lines 21 through 34: Service Category ....................................................................................................... 5.2

Chapter 6: Quality of Care Indicators (Table 6b)In This Chapter ................................................................................................................................................ 6.1Report Options ................................................................................................................................................ 6.2Section A (Lines 1-6): Age Categories for Prenatal Care Patients: Demographic

Characteristics of Prenatal Care Patients........................................................................................... 6.2Section B (Lines 7-9): Early Entry into Prenatal Care ............................................................................... 6.3Overview of Sections C–M (Lines 10–21) .................................................................................................... 6.4

Clinical Data for a Specific Patient....................................................................................................... 6.4Columns in Sections C through M of Table 6B .................................................................................. 6.5

Section C (Line 10): Childhood Immunization Status (CMS117v6) ....................................................... 6.6Section D (Line 11): Cervical Cancer Screening (CMS124v6).................................................................. 6.6Section E (Line 12): Weight Assessment and Counseling for Nutrition and Physical

Activity for Children and Adolescents (CMS155v6)........................................................................... 6.7Section F (Line 13): Preventive Care and Screening: Body Mass Index (BMI)

Screening and Follow-Up (CMS69v6) .................................................................................................. 6.7Section G (Line 14a): Preventive Care and Screening: Tobacco Use: Screening and

Cessation Intervention (CMS138v6)..................................................................................................... 6.8Section H (Line 16): Use of Appropriate Medications for Asthma (CMS126v5)................................... 6.8

Line 16, Column A: Total Patients aged 5 through 64 with Persistent Asthma........................... 6.9Line 16, Column B: Charts Sampled or EHR Total ............................................................................ 6.9Line 16, Column C: Number of Patients with Acceptable Plan ...................................................... 6.9Exclusions ................................................................................................................................................. 6.9

Section I (Line 17): Coronary Artery Disease (CAD): Lipid Therapy (no eCQM) ................................. 6.10Line 17, Column A: Total Patients Aged 18 and Older with CAD Diagnosis ............................... 6.10Line 17, Column B: Number Charts Sampled or EHR Total .......................................................... 6.11Line 17, Column C: Number of Patients Prescribed a Lipid Lowering Therapy........................ 6.11Exclusions ............................................................................................................................................... 6.11

Section J (Line 18): Ischemic Vascular Disease (IVD): Use of Aspirin orAnother Antiplatelet (CMS164v6) ....................................................................................................... 6.12

Section K (Line 19): Colorectal Cancer Screening (CMS130v6)............................................................ 6.12Section L (Line 20): HIV Linkage to Care (no eCQM)............................................................................... 6.13

Line 20, Column A: Total Patients First Diagnosed with HIV......................................................... 6.13Line 20, Column B: Charts Sampled or EHR Total .......................................................................... 6.13Line 20, Column C: Number of Patients Seen Within 90 Days of First Diagnosis of HIV.......... 6.13Exclusions ............................................................................................................................................... 6.14

Section M (Line 21): Preventive Care and Screening: Screening for Depression and Follow-up Plan (CMS2v7)............................................................................................................. 6.14

Chapter 7: Health Outcomes and Disparities (Table 7)In This Chapter ................................................................................................................................................ 7.1Report Options ................................................................................................................................................ 7.1Overview ........................................................................................................................................................... 7.1Section A: Deliveries and Birth Weight ....................................................................................................... 7.2

Line 0: HIV Positive Pregnant Women ................................................................................................. 7.2Line 2: Deliveries Performed by Health Center Provider ................................................................. 7.2Remaining Lines of Section A ............................................................................................................... 7.2

Section B: Controlling High Blood Pressure (CMS165v6) ....................................................................... 7.3Section C: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9 percent) (CMS122v6)................... 7.4

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Chapter 8: Financial (Table 9)In This Chapter ................................................................................................................................................ 8.1Report Options ................................................................................................................................................ 8.1Overview ........................................................................................................................................................... 8.1Line 1 through Line 12 ................................................................................................................................... 8.2Line 13 ............................................................................................................................................................... 8.3

Appendix A: Service Area Table

Appendix B: Tables 3a, 3b, and 4

Appendix C: Table 5

Appendix D: Table 6a

Appendix E: Table 6b

Appendix F: Table 7

Appendix G: Table 9

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Preface

From all of us here at Henry Schein Medical Systems, Inc., thank you for selecting MicroMD. This supplemental guide is a quick reference to the UDS reporting tables supported by MicroMD.

How This Guide is Organized

This guide was organized according to the UDS tables and the sections/lines within each table. Each section explains how MicroMD determines the values of the various UDS reporting tables. For in-depth information about MicroMD PM or MicroMD EMR, please refer to that software’s user’s reference manual.

Conventions Used in This Guide

Before using this guide, it is important to understand the typographical conventions used to identify and describe information.

Cross-References

Cross-references to chapters, sections, page numbers, headings, etc. are shown in an italic typeface.

e.g., Refer to Conventions Used in This Guide page i.

Text You Type Using the Keyboard

Text that you type using the keyboard is shown in a Courier typeface.

e.g., Type Anthony Smith in the Name field.

Keys You Press and Buttons You Click

Keys that you press on the keyboard and buttons/icons that you click with the mouse are shown in a bold sans-serif typeface.

e.g., Press Enter.

e.g., Click OK to continue.

Dialog Box, Application Window Titles, and Field Names

The titles of dialog boxes and application windows are shown in italics. Field names and selections made from drop-down menus, etc. are also shown in italics.

e.g., The Print Preview dialog box appears.

e.g., Select Commercial Insurance from the drop-down list.

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Preface Conventions Used in This Guide

Warnings, Notes and Tips

Warnings, notes and tips appear throughout the guide. They provide additional information important for you to know about a topic.

Warning Table

Note Table

Tip Table

� A warning alerts you to a severe situation, a potential for data loss, or other critical information about the actions discussed in the instructions.

○A note highlights some important information you need to know to use the features of the system correctly or to get the results you expect.

�� This type of tip highlights helpful information you may not know about the system or feature.

�This type of tip contains a reference to some related information or a related feature on another page or in another section of the manualguide.

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Overview of MicroMD PM and UDS Reports

Overview

The MicroMD PM UDS Reporting Guide provides you with information on what you can do in MicroMD to meet the requirements of each UDS reporting table. For detailed instructions on using either MicroMD PM or MicroMD EMR, please refer to the appropriate user’s reference manual.

We have organized this guide into chapters based on the UDS tables, and you can find screenshots of the tables in the appendix for your reference.

Reporting Dates

Regardless of the dates you choose in the report options windows when generating your reports, the system uses the most recent UDS requirements to generate the data.

For example, Happy Family Center has upgraded to the version of MicroMD PM that contains the updated reporting requirements for the 2018 performance year (that you report in 2019). If Betty enters 1/1/2017 through 12/31/2017 in the Table 6b report options, the data displayed uses the 2018 requirements, not 2017 requirements.

Terminology

For the purposes of this document, you need to understand what we mean when we refer to a “qualifying visit”. MicroMD deals with charge lines and sequences. When we refer to a “qualifying visit”, we refer to a charge line for a procedure code where the Service Category is marked as an Encounter category. Any other charge lines that occur on the same date of service, for the same provider, and at the same location will be counted as being part of that same qualifying visit, even if those lines are in a different sequence.

For example, you have a Service Category called OFFICE VISITS (Figure 1.1). You placed a check mark in the Encounter checkbox for that category.

Figure 1.1 Marking a Category as a Visit Category

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Chapter 1. Overview of MicroMD PM and UDS Reports Changes for Performance Year 2018

When you set up your procedure codes in the MicroMD CHC module, you associated each “visit” procedure code with the OFFICE VISIT Service Category (Figure 1.2).

Figure 1.2 Associate a Procedure with a Service Category

Changes for Performance Year 2018

Each year, the Department of Health Resources and Services Administration (HRSA) releases an update to their requirements for reporting health center data. Version 15.0 reflects the updates necessary to meet these reporting requirements.

The following changes were made for the reports in MicroMD PM:

Table 6a: Procedure and diagnosis codes were updated.

Table 6b Sections:

- Section C: Childhood Immunization Status has been revised to align with CMS117v6

- Section D: Cervical Cancer Screening has been revised to align with CMS124v6

- Section E: Weight Assessment and Counseling for Nutrition and Physical Activity for

Children and Adolescents has been revised to align with CMS155v6

- Section F: Body Mass Index (BMI) Screening and Follow-Up Plan has been revised to align

with CMS69v6

- Section G: Tobacco Use Screening and Cessation Intervention has been revised to align

with CMS138v6

- Section J: Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet has been

revised to align with CMS164v6

- Section K: Colorectal Cancer Screening has been revised to align with CMS130v6

- Section M: Screening for Clinical Depression and Follow-Up Plan has been revised to align

with CMS2v7

○ For changes made other than those made by HRSA, please see the most recent MicroMD PM Update Guide.

�For in-depth details on the requirements for the 2018 performance year, please check out the official UDS manual online: http://www.bphcdata.net/docs/uds_rep_instr.pdf.

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Changes for Performance Year 2018 Chapter 1. Overview of MicroMD PM and UDS Reports

Table 7 Sections:

- Section A Changes:

• Changed section title to “Section A: Low Birth Weight”

- Section B Changes:

• Section has been revised to align with CMS165v6

• Changed section title to “Section B: Controlling High Blood Pressure”

• Changed column header from “Total Hypertensive Patients (2a)” to “Total Patients 18

through 85 Years of Age with Hypertension (2a)”

- Section C Changes:

• Removed column “Patients with Hba1c <8% (3d1)”to align with CMS122v6 and the

Healthy People 2020 national benchmark

• Changed section title to “Section C: Diabetes: Hemoglobin A1c Poor Control”

• Changed column header from “Total Patients with Diabetes (3a)” to “Total Patients 18

through 75 years of Age with Diabetes (3a)”

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Chapter 1. Overview of MicroMD PM and UDS Reports Changes for Performance Year 2018

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Service Area Report

The Service Area report allows the health center to report the number of patients (and their primary insurance plans) by ZIP code. This information will enable Bureau of Primary Health Care (BPHC) to better identify areas served by health centers. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Service Area from the main menu. Table 2.1 explains the fields in more detail.

In This Chapter

In this chapter, we cover:

Report Options (page 2.1)

ZIP Code Data (page 2.1)

Report Options

To generate the report, you need to establish the report’s parameters. Each of the patients included in the report must meet the criteria you set on the report options window.

ZIP Code Data

For every patient that MicroMD PM includes in the ZIP Code report, there must be at least one qualifying visit posted to the patient’s account with a Service Date that falls within the date range you enter in the Date of Service fields on the report options window. In addition, MicroMD PM looks at the active primary plan for the plan set listed in the Primary Medical Plan Set drop-down (on the Patient Profile Detail tab of the Patient Detail window).

Figure 2.1 Primary Medical Plan Set on the Patient Detail Window

Table 2.1 Report Options Available for Service Area

Field Description

Date of Service Select the service date range for which you want to generate a report. The default date is January 1 to December 31 of the previous year.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

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Chapter 2. Service Area Report ZIP Code Data

○For those ZIP codes with 10 or fewer patients that meet the criteria of the report, MicroMD PM includes those patients in the Other Zip Codes line.

�The total number of patients in the Service Area report should match the totals on Table 3a (page 3.2). If the totals on Table 3a are higher than the Service Area Report, this typically means there are patients whose Primary Medical Plan Set field is not set (Figure 2.1).

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Patient Profile (Tables 3A, 3B, and 4)

The Patient Profile tables allow you to report necessary user demographic data along with socioeconomic information required in the Universal Report and the Grant Reports for your practice. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Patient Profile - Table 3A, 3B, 4 from the main menu.

In This Chapter

In this chapter, we cover:

Report Options (page 3.1

Table 3a – Universal Patients by Age and By Sex Assigned at Birth (page 3.2)

Table 3b – Demographic Characteristics (page 3.3)

Table 4 – Selected Patient Characteristics (page 3.5)

Report Options

For the Tables 3a, 3b, and 4 (Patient Profile) report, you need to set your report options. These allow you to specify the date range, practice location, provider and more for the report you need to submit. Table 3.1 explains these fields in detail.

�If you want to see the list of patients included in the report numbers, simply click the Show Details icon ( ) in the Task Pane once you generate the report.

Table 3.1 Report Options Available for UDS Tables 3a and 3b, 4 (Patient Profile)

Field Description

Date of Service Select the service date range for which you want to generate a report. The default date is January 1 to December 31 of the previous year. You can change this as needed.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

Diagnosis If you want to generate a report for those patients with only certain diagnosis code(s), select the appropriate code(s) from the Diagnosis drop-down list. You can limit the report even more by selecting a diagnosis/procedure code combination if needed.

Procedure If you want to generate a report for those patients with only certain procedure code(s), select the appropriate code(s) from the Procedure drop-down list. You can limit the report even more by selecting a diagnosis/procedure code combination if needed.

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Chapter 3. Patient Profile (Tables 3A, 3B, and 4) Table 3a – Universal Patients by Age and by Sex Assigned at

Table 3a – Universal Patients by Age and by Sex Assigned at Birth

For Table 3a, MicroMD PM looks at DOB field and the Sex field on the Patient Detail window. The system looks at this for all of the unique patients in your practice where at least one of the qualifying visits posted to their account has a Service Date that falls within the date range you enter in the Date of Service fields on the report options window. For this report, MicroMD PM counts each patient only once and breaks down the number of patients by male and female.

Age computed as of Select the effective date for the calculation of the patients’ ages in the report. The field defaults to June 30 of the previous year.

Compute percent of poverty based on

Edit the Compute percent of poverty based on field if necessary. The default value pulls from the Base Annual Poverty Level field on the Sliding Fee Schedule Setup tab (under Aux > MicroMD CHC > Setup > Practice). The system uses the row set to ALL in the Plan Sets column.

Each additional family member at

Edit the Each additional family member at field if necessary. The default value pulls from the Base Annual Additional Member field on the Sliding Fee Schedule Setup tab (under Aux > MicroMD CHC > Setup > Practice). The system uses the row set to ALL in the Plan Sets column.

Report Type In the Report Type section, identify if you want the system to generate a universal report or one based on 330g, 330h or 330i grant information.

Show Details Place a check mark in the Show Details option to display a list of the patients that MicroMD PM used to calculate each of the numbers in the generated report.

�Remember that the patients included in the report must have also met the criteria you set in the report options (page 3.1).

Table 3.1 Report Options Available for UDS Tables 3a and 3b, 4 (Patient Profile) (continued)

Field Description

�Once you generate the report, you can also click the Show Details or Suppress Details icon ( ) in the Task Pane to show/hide the patient list, regardless if you choose this option.

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Table 3b – Demographic Characteristics Chapter 3. Patient Profile (Tables 3A, 3B, and 4)

Figure 3.1 Patient Detail Window

The system calculates the patient’s age as of the date entered in the Age computed as of report option.

Table 3b – Demographic Characteristics

In Table 3b, MicroMD PM looks at the Patient Detail window for all of the unique patients in your practice where at least one of the qualifying visits posted to their account has a Service Date that falls within the date range you enter in the Date of Service fields on the report options window. The system then breaks down the race, language, ethnicity, sexual orientation and gender identity data of those patients.

Lines 1 through 8: Patients by Race

For Line 1 through Line 8, MicroMD PM counts each patient only once and breaks down the number of patients by race and ethnicity. The system finds this data on the Patient Detail window in the Race and Ethnicity fields (Figure 3.2).

Figure 3.2 Race and Ethnicity on the Patient Detail Window

Keep in mind that, in MicroMD PM, it is possible to choose multiple ethnicities from the Race and Ethnicity fields:

○The total number of patients displayed in Table 3a must equal the total patients displayed in Table 3b (Line 8) and in Table 4 (Line 6).

�Remember that the patients included in the report must have also met the criteria you set in the report options (page 3.1).

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Chapter 3. Patient Profile (Tables 3A, 3B, and 4) Table 3b – Demographic Characteristics

If a staff member enters multiple races in the Race field, the system automatically translates

that into Line 6 (More than one Race).

If a staff member enters multiple ethnicities in the Ethnicity field and one of those entries is

Hispanic, MicroMD PM includes the patient in the Hispanic/Latino column on the report. Otherwise, the patient counts in the Non-Hispanic/Latino column.

If a staff member enters Declined to Specify in both the Race and Ethnicity fields, MicroMD PM

includes the patient in the Unreported/Refused to Report Ethnicity column. In all others cases, the patient counts in the Non-Hispanic/Latino column.

Line 12: Patients by Language

In Line 12, MicroMD PM counts each patient only once and displays the number of patients with a check mark in the Limited English Proficiency checkbox (on the Patient Profile Detail tab of the Patient Detail window).

Figure 3.3 Limited English Proficiency on the Patient Detail Window

Lines 13 through 19: Patients by Sexual Orientation

For Line 13 through Line 19, MicroMD PM counts each patient only once and breaks down the number of patients by sexual orientation. The system finds this data on the Patient Detail window in the Sexual Orientation field (Figure 3.4).

Figure 3.4 Sexual Orientation on the Patient Detail Window

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Table 4 – Selected Patient Characteristics Chapter 3. Patient Profile (Tables 3A, 3B, and 4)

Lines 20 through 26: Patients by Gender Identity

For Line 20 through Line 26, MicroMD PM counts each patient only once and breaks down the number of patients by the gender with which they identify. The system finds this data on the Patient Detail window in the Gender Identity field (Figure 3.5).

Figure 3.5 Gender Identity on the Patient Detail Window

Table 4 – Selected Patient Characteristics

Table 4 displays data related to your patients’ financial characteristics, as well as details about special populations.

Lines 1 through 6: Income as Percent of Poverty Level

Line 1 through Line 6 in Table 4 pull the data from the Family Size and Family Income fields (on the Patient Profile Detail tab of the Patient Detail window) for each patient and calculates the number of patients for each line using the dollar amount you enter in the Compute percent of poverty based on report option.

Figure 3.6 Family Size and Family Income on the Patient Detail Window

�Remember that the patients included in the report must have also met the criteria you set in the report options (page 3.1).

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Chapter 3. Patient Profile (Tables 3A, 3B, and 4) Table 4 – Selected Patient Characteristics

Lines 7 through 12: Principal Third-Party Medical Insurance Source

For Line 7 through Line 12, MicroMD PM looks at the active primary plan for the plan set listed in the Primary Medical Plan Set drop-down (on the Patient Profile Detail tab of the Patient Detail window). See Figure 2.1 on page 2.1.

For Line 9a, if the primary in that plan set is Medicare, the system also looks at the secondary plan in that plan set to see if the patient also has Medicaid and enters the information in Line 9a accordingly.

Based on this information, the system looks at the CHC Payor Category field of that plan’s Plan Detail window to determine in which line the patient should be counted.

The system calculates the patient’s age as of the date entered in the Age computed as of report option and includes the patient in the appropriate column.

Lines 13a through 13c: Managed Care Utilization

MicroMD PM also bases Line 13a through Line 13c on the active primary plan for the plan set listed in the Primary Medical Plan Set drop-down (on the Patient Profile Detail tab of the Patient Detail window). Either one or both of the Effective From and Effective To dates on that primary plan must fall within the Date of Service range entered when generating the report.

Figure 3.7 Effective Dates for the Patient’s Primary Plan

The system compares the plan’s effective dates with the Date of Service range entered for the report to determine the number of months the patient was covered. The CHC Payor Category on the plan (Figure 8.1 on page 8.2) must reflect a managed care category.

�You can find the list of Payor Category system codes under Setup > Master Table. Please see the main MicroMD PM User’s Reference Manual for more details.

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Table 4 – Selected Patient Characteristics Chapter 3. Patient Profile (Tables 3A, 3B, and 4)

Lines 14 through 26: Characteristics – Special Populations

For Line 14 through Line 26, MicroMD PM pulls information from the Social section of the Patient Profile Detail tab (on the Patient Detail window).

Figure 3.8 Social Section of the Patient Detail Window

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Staffing and Utilization (Table 5)

This report in MicroMD PM consolidates information on staffing full-time equivalents by position, and visits and patients by provider type and service type. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Staffing and Utilization - Table 5 from the main menu. Table 4.1 on page 4.1 explains the options for this report in more detail.

In This Chapter

In this chapter, we cover:

Prerequisites for the information in the report (page 4.1)

Report options (page 4.1)

Column descriptions (page 4.2)

Prerequisites for Information in the Report

Before the information displayed in this report can be accurate, you need to ask the following questions:

Have we created service categories on the Service Categories tab (under Aux > MicroMD CHC >

Setup > Practice)?

Have we assigned those service categories to the appropriate procedure codes on the

Procedure List window (under Aux > MicroMD CHC > Setup > Procedure)? These procedures count for the reporting when an encounter code also exists for the patient with the same provider, location, and date of service.

Have we made a selection in the Major Service Category drop-down on the CHC module’s

Provider Detail window for every provider to be included on the report (under Aux > MicroMD CHC > Setup > Provider)?

Have we calculated each provider’s full-time equivalency and entered that information on the

Full Time Equivalency field on the CHC module’s Provider Detail window (for those providers for whom we want to report)?

Report Options

To generate the Staffing and Utilization Report, you need to establish your reporting criteria. Table 4.1 explains the options in detail.

Table 4.1 Report Options Available for Staffing and Utilization - Table 5

Field Description

Date of Service Select the service date range for which you want to generate a report. The default date is January 1 to December 31 of the previous year. You can change this as needed.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

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Chapter 4. Staffing and Utilization (Table 5) Columns on Table 5

Columns on Table 5

The information in the columns of Table 5 bases the information displayed on those sequences where the Service Date of the sequence falls within the date range you enter in the Date of Service fields on the report options window.

Column A: FTEs

The provider’s Full Time Equivalency and Major Service Category are both set under Aux > MicroMD CHC > Setup > Provider on the main menu. There must be at least one transaction posted for a provider for that provider to be counted on the report.

Column B: Clinic Visits

The number displayed in the Clinic Visits column reflects the total number of qualifying visits posted for the providers listed in the FTEs column. This includes all patient visits for providers with that Major Service Category, even if the patient was seen more than once or by multiple providers, provided that the visits occurred on separate dates of service.

There are a few conditions:

There must be a charge line with a procedure code that has a Service Category associated with

it where the Service Category is marked as “encounter”. This means there is a check mark in the Encounter column (Figure 4.1) for the Service Category. All charge lines posted for the patient with the same provider, date of service and location, will be considered part of the same visit, even if those other lines are not encounter codes.

Figure 4.1 Service Category for Encounter/Visit Codes

Report Type In the Report Type section, identify if you want the system to generate a universal report or one based on 330g, 330h or 330i grant information.

Show Details To include a detailed list of the patients included in the numbers of the report, place a check mark in the Show Details checkbox. You can only choose either Show Details or Show Provider Details for the report. You cannot choose both.

Show Provider Details Place a check mark in this checkbox to include totals for each provider as a line item in each category. You can only choose either Show Details or Show Provider Details for the report. You cannot choose both.

Table 4.1 Report Options Available for Staffing and Utilization - Table 5 (continued)

Field Description

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Columns on Table 5 Chapter 4. Staffing and Utilization (Table 5)

MicroMD PM uses the Service Date on the charge line, not the sequence-level Service Date.

This date must fall within the date range entered in the Date of Service fields on the report options window.

On this report, a patient cannot be counted as having multiple visits with the same provider

on the same service date, even if there are multiple encounter codes, or the patient was seen at multiple locations.

Column C: Patients

MicroMD PM only displays the total number of unique patients with sequences posted during the date range entered in the Date of Service fields on the report options window for those providers in the Major Service Categories above the total line.

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Chapter 4. Staffing and Utilization (Table 5) Columns on Table 5

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Selected Diagnoses and Services Rendered (Table 6a)

Table 6a consolidates posting information and reports on primary diagnoses for medical visits and selected services provided. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Selected Diagnoses and Services Rendered - Table 6A from the main menu. Table 5.1 explains the fields in more detail.

In This Chapter

In this chapter, we cover:

Report Options (page 5.1)

Lines 1 through 20d: Diagnostic Category (page 5.2)

Lines 21 through 34: Service Category (page 5.2)

Report Options

To generate the report, you must first establish your reporting criteria. Only patients who meet the criteria on the report options appear on the report. Table 5.1 explains the options in detail.

○This table looks at transaction lines that are considered to be part of a qualifying visit. The individual lines do not need to be encounter codes as long as a charge line with an encounter code exists for the patient with the same provider, location and date of service.

Table 5.1 Report Options Available for Table 6A

Field Description

Date of Service Select the service date range for which you want to generate a report. The default date is January 1 to December 31 of the previous year. You can change this as needed.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

Report Type In the Report Type section, identify if you want the system to generate a universal report or one based on 330g, 330h or 330i grant information.

Show Details To include a detailed list of the patients included in the numbers of the report, place a check mark in the Show Details checkbox. You can only choose either Show Details or Show Provider Details for the report. You cannot choose both.

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Chapter 5. Selected Diagnoses and Services Rendered (Table 6a) Lines 1 through 20d: Diagnostic Category

Lines 1 through 20d: Diagnostic Category

For Line 1 through Line 20d, MicroMD PM counts only those charge lines where the service date of the procedure falls within the date range you entered in the Date of Service fields on the report options window. For each line:

Column A reflects the transaction lines that have diagnosis pointers referencing the indicated

diagnosis code(s). A charge line can be counted in multiple diagnosis categories.

If a patient has more than one transaction with the indicated diagnosis code(s), the transactions

will only be counted in Column A once per service date.

Column B reflects the total unique patients to whom those charges were posted. For this

column, each patient can be counted only once per diagnosis category, regardless of the number of visits for that diagnosis.

Lines 21 through 34: Service Category

For Line 21 through Line 34, MicroMD PM counts only those transaction lines where the service date of the transaction falls within the date range you entered in the Date of Service fields on the report options window. For each line:

Column A reflects only those transaction lines within that date range that contain the indicated

diagnosis and/or procedure code(s).

Column B reflects the total number of unique patients to whom those transaction lines were

posted.

For example, Linsey Homer came in on January 15, 2018, and Dr. Webb counseled her to quit smoking and drinking. Linsey came in again on May 2, 2018, and Dr. Webb had another talk with her about her bad habits and how to correct them. When Happy Family Center generated their Table 6a report, both services would count in Column A of Line 26c, but Linsey would count only once in Column B for that line.

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Quality of Care Indicators (Table 6b)

Table 6: Quality of Care Indicators reports data on certain Clinical Quality Measures (CQMs) consistent with the National Quality Strategy and other national quality initiatives. The quality measures for the UDS report tables align closely to the CQMs outlined by the Centers for Medicaid and Medicare (CMS). Each heading in this chapter identifies the CQM to which the section aligns.

In This Chapter

In this chapter, we cover:

Report Options (page 6.2)

Section A (Lines 1-6): Age Categories for Prenatal Care Patients: Demographic Characteristics of

Prenatal Care Patients (page 6.2)

Section B (Lines 7-9): Early Entry into Prenatal Care (page 6.3)

Section C (Line 10): Childhood Immunization Status (page 6.6)

Section D (Line 11): Cervical Cancer Screening (page 6.6)

Section E (Line 12): Weight Assessment and Counseling for Nutrition and Physical Activity for

Children and Adolescents (page 6.7)

Section F (Line 13): Preventive Care and Screening: Body Mass Index (BMI) Screening and

Follow-Up (page 6.7)

Section G (Line 14a): Preventive Care and Screening: Tobacco Use: Screening and Cessation

Intervention (page 6.8)

Section H (Line 16): Use of Appropriate Medications for Asthma (page 6.8)

Section I (Line 17): Coronary Artery Disease (CAD): Lipid Therapy (page 6.10)

Section J (Line 18): Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet

(page 6.12)

Section K (Line 19): Colorectal Cancer Screening (page 6.12)

Section L (Line 20): HIV Linkage to Care (page 6.13)

Section M (Line 21): Preventive Care and Screening: Screening for Depression and Follow-up

Plan (page 6.14)

�For a patient to be included in this UDS report, they must have a qualifying visit within the year you enter in the Dates of Service field on the report options window. Refer to page 1.1 for details on what is a qualifying visit. If the patient does not appear in Table 3a (page 3.2), they will not appear in Table 6b.

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Chapter 6. Quality of Care Indicators (Table 6b) Report Options

Report Options

This report in MicroMD PM consolidates information on Quality of Care Indicators. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Quality of Care Indicators - Table 6B from the main menu. Table 6.1 explains the fields in more detail.

Section A (Lines 1-6): Age Categories for Prenatal Care Patients: Demographic Characteristics of Prenatal Care Patients

In this section, you need to report the age of all prenatal care patients you have seen during the reporting year. You identify a prenatal patient with the Prenatal User checkbox on the Patient Profile Detail tab (under Maint > Patient > open the patient’s account).

Figure 6.1 Prenatal Section of Patient Detail

In order for those patients to be counted, the patient must also have a pregnancy listed in the Pregnancy History section of the Patient Profile Detail tab (Figure 6.2) where either the date entered in the First Prenatal Visit field OR the date entered in the Delivery Date / End of Pregnancy field is between January 1 and December 31 of the year you enter on the report options window.

Figure 6.2 Pregnancy History Section of Patient Detail

Table 6.1 Report Options Available for Quality of Care Indicators - Table 6B

Field Description

Date of Service Enter the performance year for which you want to generate a report.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

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Section B (Lines 7-9) Chapter 6. Quality of Care Indicators (Table 6b)

Section B (Lines 7-9): Early Entry into Prenatal Care

Section B compiles information about when your prenatal care patients began to receive care. You identify a prenatal patient with the Prenatal User checkbox on the Patient Profile Detail tab (under Maint > Patient > open the patient’s account). See Figure 6.1 on page 6.2.

MicroMD PM pulls the information for Lines 7–9 and separates the numbers based on the Began Prenatal Care in Trimester checkboxes you can find on the Pregnancy Detail window (Figure 6.3).

Figure 6.3 Pregnancy Detail Window

In addition, that pregnancy only counts when either the date entered in the First Prenatal Visit field OR the date entered in the Delivery Date / End of Pregnancy field for that pregnancy is between January 1 and December 31 of the year you enter on the report options window.

�Prenatal information entered in MicroMD PM syncs automatically with the prenatal information in the EMR (and vice versa).

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Chapter 6. Quality of Care Indicators (Table 6b) Overview of Sections C–M (Lines 10–21)

Overview of Sections C–M (Lines 10–21)

The remainder of Table 6B reports on a variety of quality measures consistent with the national quality initiatives. Many of the sections align with Clinical Quality Measures outlined by the Centers for Medicare and Medicaid (CMS) for their incentive programs.

In this UDS reporting guide, we refer you to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for details on how the system calculates the numbers in each column.

Clinical Data for a Specific Patient

If you question whether a patient should be included in a line item on the Table 6B report for Lines 10 through 21, MicroMD PM provides a window where you can see whether a specific patient currently meets the conditions to appear for each line of the table. You can find this window on the patient’s account under Maint > Patient. Open the patient’s account and click the Patient Profile Detail tab. When you click the Clinical Quality Measure Data button, the system displays the Patient - CHC UDS Clinical Data window (Figure 6.4). An overnight process runs each day to update this data based on entries made or changed in MicroMD EMR.

Figure 6.4 Patient - CHC UDS Clinical Data Window

Enter the reporting year you want to check and click the View button. The system displays a check mark in each of the conditions that the patient meets. If there is no check mark, the patient did not meet the condition.

� You can find the document on the MicroMD Lounge at http://www.micromd.net/index.php?topic=451.0.

○If you do not have MicroMD PM + EMR, you can edit this window to populate the report accordingly. Otherwise, the data is read-only and displays the information entered from MicroMD EMR.

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Overview of Sections C–M (Lines 10–21) Chapter 6. Quality of Care Indicators (Table 6b)

Columns in Sections C through M of Table 6B

The Bureau of Primary Health Care (BPHC) has divided each section into three columns. These columns reflect the numbers used to calculate your compliance with each measure. Most sections align with the Clinical Quality Measures (CQM) outlined by the Centers for Medicare and Medicaid (CMS). Even though the measures are aligned, you should not expect the actual numbers between the PM and the EMR to match. When we refer to the CQM, this is meant to explain how the system gathers patient data from the EMR to then apply the requirements of the UDS reports.

Column A (Denominator): This column reflects the number of patients in the universe of the

measure.

Column B (becomes the Denominator): Since you are using MicroMD PM and MicroMD EMR (or

MicroMD PM alone), Column B will always be the same as Column A.

Column C (Numerator): In Column C, the report displays the total number of patients in Column

A who meet the measurement standard for the measure.

�When you highlight a condition, MicroMD PM displays the UDS report table and line number, along with a brief description, at the bottom of the window. (Use the arrow keys on the keyboard to navigate the list quickly.)

�Click the Refresh from EMR button to rebuild the quality measures data for the patient. You can also rebuild the clinical data for all patients under Aux > MicroMD CHC > Utilities > Refresh Clinical Data. These actions clear out the existing data and refresh the data with the most current information.

○Do not compare the numbers in Column A of Table 6B with numbers calculated for Table 3A. They WILL NOT be equal because the patient populations are different.

�You can calculate the percentage of patient records meeting the measurement standard by dividing Column C by Column B.

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Chapter 6. Quality of Care Indicators (Table 6b) Section C (Line 10)

Section C (Line 10): Childhood Immunization Status (CMS117v6)

For Line 10, the report displays the numbers needed to calculate the “Percentage of children 2 years of age who had four diphtheria, tetanus and acellular pertussis (DTaP); three polio (IPV), one 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”

The UDS measure aligns with the Clinical Quality Measure displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

Column A (Total Patients with 2nd Birthday): Use the instructions from the Denominator in the

CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients Immunized): Use the instructions from the Numerator in the

CQM.

Click here for a searchable list of codes used for this measure.

Section D (Line 11): Cervical Cancer Screening (CMS124v6)

For Line 11, the report displays the numbers needed to calculate the “Percentage of women 21*–64 years of age who were screened for cervical cancer using either of the following criteria:

Women age 21*-64 who had cervical cytology performed every 3 years

Women age 30-64 who had cervical cytology/human papilloma virus (HPV) co-testing

performed every 5 years.”

The UDS measure aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

○* Per CMS: “To ensure the measure is only looking for a cervical cytology test only after a woman turns 21 years of age, the youngest age in the initial population is 23.”

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

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Section E (Line 12) Chapter 6. Quality of Care Indicators (Table 6b)

Column A (Total Female Patients 23–64 Years of Age): Use the instructions from the

Denominator in the CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients Tested): Use the instructions from the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

Section E (Line 12): Weight Assessment and Counseling for Nutrition and Physical Activity for Children and Adolescents (CMS155v6)

Line 12 reports on the “Percentage of patients 3–17 years of age who had an outpatient medical visit and who had evidence of height, weight, and body mass index (BMI) percentile documentation and who had documentation of counseling for nutrition and who had documentation of counseling for physical activity during the measurement period”.

The UDS measure mostly aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. The only difference between the UDS measure and the CQM referenced above is that the UDS report does not separate the data into different percentages. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

Column A (Total Patients Aged 3–17): Use the instructions from Denominator X in the CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients with Counseling and BMI Documented): Use the instructions for

all three Numerator conditions; however, in the UDS report, a patient appears in Column C only if they meet all three numerator conditions in the CQM.

Click here for a searchable list of codes used for this measure.

Section F (Line 13): Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up (CMS69v6)

Line 13 reports on the “Percentage of patients aged 18 years and older with BMI documented during the most recent visit or within the previous 12 months to that visit and when the BMI is outside of normal parameters, a follow-up plan is documented during the visit or during the previous 12 months of that visit.”

The UDS measure aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

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Chapter 6. Quality of Care Indicators (Table 6b) Section G (Line 14a)

Column A (Total Patients 18 and Over): Use the instructions from the Denominator in the CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients with BMI Charted and Follow-up Plan Documented as

Appropriate): Use the instructions from the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

Section G (Line 14a): Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention (CMS138v6)

Line 14a reports on the “Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received cessation counseling intervention if identified as a tobacco user.”

The UDS measure aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

Column A (Total Patients Aged 18 and Older): Use the instructions from the Denominator in the

CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients Assessed for Tobacco Use and Provided Intervention if a

Tobacco User): Use the instructions from the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

Section H (Line 16): Use of Appropriate Medications for Asthma (CMS126v5)

Line 16 reports on the “Percentage of patients 5-64 years of age who were identified as having persistent asthma and were appropriately ordered medication during the measurement period.”

Click here for a searchable list of codes used for this measure.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

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Section H (Line 16) Chapter 6. Quality of Care Indicators (Table 6b)

Line 16, Column A: Total Patients aged 5 through 64 with Persistent Asthma

Column A displays the total number of patients in your practice whose age MicroMD calculates to be greater than or equal to 5 and less than 64 by the end of year you enter in the Dates of Service field on the report options window.

In addition, the patient must have an active persistent asthma diagnosis recorded in their chart in the EMR where the date in the Onset field is before the end of the measurement period (or during previous years). (If the Status on the diagnosis is Resolved or Inactive, the date in the Status Date field must be after the beginning of the measurement period for the patient to be included in the denominator.) MicroMD looks in the following locations in the EMR for an accepted diagnosis code:

Medical Information tab > Medical > Problem List (includes Active, Inactive or Resolved)

Encounter > Assessment tab

Medical Information tab > Histories > Hospitalization History (Diagnoses field)

Medical Information tab > Histories > Medical History (Diagnosis field)

Medical Information tab > Histories > Surgical Procedures > Medical Details tab (Diagnosis before operation and Diagnosis after operation fields)

Medical Information tab > Orders > Laboratory Orders (Diagnoses field)

There must also be an encounter created in MicroMD EMR with an accepted “visit code”. The Service Date on the encounter should fall within the measurement period. You must enter an accepted encounter code in one of the following locations of the encounter:

Encounter > Encounter Header > Encounter Level drop-down (CPT codes)

Encounter > Plan tab > Procedure Orders (if you use SNOMED visit codes)

You can find the list of patient encounters in the patient’s chart on the Summary tab in the EMR.

Line 16, Column B: Charts Sampled or EHR Total

In MicroMD PM, Column B for Line 16 will always be identical to Column A.

Line 16, Column C: Number of Patients with Acceptable Plan

The numerator in MicroMD reflects the number of patients within the denominator who received at least one prescription for a preferred therapy during the measurement period. MicroMD checks the following location in the EMR for an accepted medication:

Medical Information tab > Medical > Medications

Exclusions

MicroMD counts as Exclusions those patients who have a diagnosis of chronic obstructive pulmonary disease (COPD), obstructive chronic bronchitis, emphysema, cystic fibrosis or acute respiratory failure during or prior to the measurement period. MicroMD checks in the following locations of the patient’s chart for an accepted diagnosis code:

Medical Information tab > Medical > Problem List (includes Active, Inactive or Resolved)

Encounter > Assessment tab

In order for the diagnosis to exclude the patient, the date in the Onset field on the diagnosis must be before the end of the measurement period. (If the Status on the diagnosis is Resolved, the date in the Status Date field must be after the beginning of the measurement period.)

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Chapter 6. Quality of Care Indicators (Table 6b) Section I (Line 17)

Section I (Line 17): Coronary Artery Disease (CAD): Lipid Therapy (no eCQM)

Line 17 reports on the “Percentage of patients aged 18 years and older with a diagnosis of CAD who were prescribed a lipid-lowering therapy.”

Click here for a searchable list of codes used for this measure.

Line 17, Column A: Total Patients Aged 18 and Older with CAD Diagnosis

Column A displays the total number of patients in your practice whose age MicroMD calculates to be greater than or equal to 18 by the end of year you enter in the Dates of Service field on the report options window.

In addition, those patients must have an encounter created in MicroMD EMR, as well as at least one sequence posted in MicroMD PM with a “visit code”, whose Service Date falls within the year you enter in the Dates of Service field on the report options window.

The patient must also have a CAD diagnosis code or a cardiac surgery procedure code in one of the following locations. The date in the Onset field for the diagnosis or the date that the surgery was performed needs to be BEFORE the Service Date on the qualifying encounter/sequence.

Coronary artery disease diagnosis (including myocardial infarction)

- Medical Information tab > Medical > Problem List

- Encounter > Assessment tab

Cardiac surgery procedure

- Encounter > Plan > Procedure Orders (with Performed status)

- Medical Information tab > Orders > Procedure Orders (with Performed status)

- Medical Information tab > Histories > Surgical Procedures

- Medical Information tab > Histories > Surgical History

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

○The patient must also have at least two encounters/sequences over the practice’s entire history in MicroMD PM with “visit codes”. (This can include the encounter/sequence that occurred during the reporting year.)

○MicroMD checks the procedure names in the Surgical History. The system includes user-defined procedures only if the user entered the appropriate CPT/HCPCS code.

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Section I (Line 17) Chapter 6. Quality of Care Indicators (Table 6b)

Line 17, Column B: Number Charts Sampled or EHR Total

In MicroMD PM, Column B for Line 17 will always be identical to Column A.

Line 17, Column C: Number of Patients Prescribed a Lipid Lowering Therapy

The number in Column C reflects the number of patients within Column B who received at least one prescription for a preferred therapy prior to the end of the year you enter in the Dates of Service field on the report options window. MicroMD checks the following location in the EMR for any of the appropriate medications:

Medical Information tab > Medical > Medications

Exclusions

If the patient is allergic to lipid-lowering medications or has had an adverse reaction to those medications, MicroMD excludes that patient from Columns A and B. MicroMD checks for allergies in the following areas of the patient’s chart in the EMR:

Medical Information tab > Medical > Allergies

Medical Information tab > Medical > Medications (End Date of the medication falls before the

end of the year you enter in the Dates of Service field on the report options window and the selection from the Code drop-down is Adverse Reaction.)

Figure 6.5 Terminating a Prescription

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Chapter 6. Quality of Care Indicators (Table 6b) Section J (Line 18)

Section J (Line 18): Ischemic Vascular Disease (IVD): Use of Aspirin orAnother Antiplatelet (CMS164v6)

Line 18 reports on the “Percentage of patients aged 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), or who had a coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCIs) in the 12 months prior to the measurement period or who had an active diagnosis of IVD during the measurement period, and who had documentation of use of aspirin or another antiplatelet during the measurement period.”

The UDS measure aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

Column A (Total Patients Aged 18 and Older with IVD Diagnosis or AMI, CABG, or PCI Procedure):

Use the instructions from the Denominator in the CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients with Documentation of Use of Aspirin or Other Antiplatelet

Therapy): Use the instructions from the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

Section K (Line 19): Colorectal Cancer Screening (CMS130v6)

Line 19 reports on the “Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer.”

The UDS measure aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

Column A (Total Patients Aged 50 through 75): Use the instructions from the Denominator in the

CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients with Appropriate Screening for Colorectal Cancer): Use the

instructions from the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

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Section L (Line 20) Chapter 6. Quality of Care Indicators (Table 6b)

Section L (Line 20): HIV Linkage to Care (no eCQM)

Line 20 reports on the “Percentage of patients newly diagnosed with HIV who were seen for follow-up treatment within 90 days of diagnosis.”

Click here for a searchable list of codes used for this measure.

Line 20, Column A: Total Patients First Diagnosed with HIV

For Column A, MicroMD PM displays the number of patients in your practice’s database who were first diagnosed with HIV between October 1 of the prior year and September 30 of the reporting year, based on the year you enter in the Dates of Service field on the report options window.

The patient must also have an encounter created in MicroMD EMR, as well as at least one sequence posted in MicroMD PM with a “visit code”, whose Service Date falls within the year you enter in the Dates of Service field on the report options window or during the previous year (e.g., reporting year 2018 or previous year 2017). You can find the list of encounters on the patient’s Summary tab in the EMR or in the list of the patient’s sequences in the PM (under Billing > Charges/Payments).

MicroMD determines the patient’s diagnosis time frame by looking for one of the accepted codes in the following locations and checking the date in the Onset field of that diagnosis.

Medical Information tab > Medical > Problem List (includes Active, Inactive or Resolved)

Encounter > Assessment tab

Medical Information tab > Histories > Hospitalization History (Diagnoses field)

Medical Information tab > Histories > Medical History (Diagnosis field)

Medical Information tab > Histories > Surgical Procedures > Medical Details tab (Diagnosis before operation and Diagnosis after operation fields)

Medical Information tab > Orders > Laboratory Orders (Diagnoses field)

Line 20, Column B: Charts Sampled or EHR Total

In MicroMD PM, Column B for Line 20 will always be identical to Column A.

Line 20, Column C: Number of Patients Seen Within 90 Days of First Diagnosis of HIV

Column C displays the number of patients from Column B who have had an encounter created in the EMR (as well as a sequence in the PM) that contains an appropriate follow-up visit code or an appropriate procedure code.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

○ There must be no HIV diagnosis entries earlier than October 1 of the prior year.

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Chapter 6. Quality of Care Indicators (Table 6b) Section M (Line 21)

The Date of Service on the encounter/“visit code” must be between one and 90 days after the date in the Onset field of the HIV diagnosis entry in the EMR.

Exclusions

There are no exclusions for this line item.

Section M (Line 21): Preventive Care and Screening: Screening for Depression and Follow-up Plan (CMS2v7)

Line 20 reports on the “Percentage of patients aged 12 years and older screened for depression on the date of the visit using an age-appropriate standardized depression screening tool and if positive, a follow-up plan is documented on the date of the positive screen.”

The UDS measure aligns with the Clinical Quality Measure (CQM) displayed in the heading to this section. Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details.

Column A (Total Patients Aged 12 and Older): Use the instructions from the Denominator in the

CQM.

Column B (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column C (Number of Patients Screened for Depression and Follow-up Plan Documented as

Appropriate): Use the instructions from the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

�Remember: If you do not use MicroMD EMR, you need to make sure that you make the appropriate selections under the Clinical Quality Measure Data button of each patient’s Patient Profile Detail tab.

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Health Outcomes and Disparities (Table 7)

This table reports indicators of overall community health and shows these selected health outcome indicators based on race and ethnicity. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Health Outcomes and Disparities - Table 7 from the main menu. Table 7.1 explains the fields in more detail.

In This Chapter

In this chapter, we cover:

Report Options (page 7.1)

Overview of the report (page 7.1)

Section A: Deliveries and Birth Weight (page 7.2)

Section B: Controlling High Blood Pressure (page 7.3)

Section C: Diabetes by Race and Hispanic/Latino Ethnicity (page 7.4)

Report Options

To generate the report, you must first establish your reporting criteria. Only patients who meet the criteria on the report options appear on the report. Table 7.1 explains the options in detail.

Overview

All of the sections in this report display data based on the race and ethnicity of the patients in your practice. For all of the sections on this report, the race and ethnicity of each patient comes from the selections made in the Race and Ethnicity fields on the Patient Detail window for the patient:

If a staff member enters multiple races in the Race field, the system automatically translates

that into Line 1f (More than one Race).

If a staff member enters multiple ethnicities in the Ethnicity field and one of those entries is

Hispanic, MicroMD PM includes the patient in the Hispanic/Latino section of the report.

If a staff member enters Non-Hispanic or All Others the Ethnicity field, MicroMD PM includes the

patient in the Non-Hispanic/Latino section of the report.

If a staff member enters Declined to Specify in the Race field AND in the Ethnicity field, MicroMD

PM includes the patient in the Unreported/Refused to Report Ethnicity section of the report.

Table 7.1 Report Options Available for Health Outcomes and Disparities - Table 7

Field Description

Date of Service Enter the performance year for which you want to generate a report.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

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Chapter 7. Health Outcomes and Disparities (Table 7) Section A: Deliveries and Birth Weight

If a staff member enters Declined to Specify in the Race field BUT NOT in the Ethnicity field,

MicroMD PM includes the patient on the Unreported/Refused to Report Race line of the relevant Ethnicity section of the report.

If a staff member enters Declined to Specify in the Ethnicity field BUT NOT in the Race field,

MicroMD PM includes the patient in the Non-Hispanic/Latino section of the report.

Section A: Deliveries and Birth Weight

Section A reports on data for those babies born with low birth weight versus normal birth weight. It also reports on the women having the babies. You can find the pregnancy information for this section in the Pregnancy History section of the Patient Profile Detail tab of the Patient Detail window (Figure 6.2 on page 6.2).

For those practices who also use MicroMD EMR: When you enter a pregnancy in this section in the PM, the system creates a new Pregnancy History record in the EMR. If you have a pregnancy created in the EMR, the system automatically completes the Pregnancy History section in the PM based on data entered in the EMR.

There must be a check mark in the Prenatal User checkbox on the Patient Profile Detail tab for the user to appear in Section A of the report.

Line 0: HIV Positive Pregnant Women

The number in Line 0 in Section A reflects all of those patients where there is a check mark in the Patient is Pregnant and HIV Positive checkbox for the current pregnancy record. This checkbox is on the Pregnancy Detail window that displays when you click the Edit icon ( ) for the pregnancy record (on the Patient Profile Detail tab of the Patient Detail window). See Figure 6.3 on page 6.3.

In addition, either the date entered in the First Prenatal Visit field or the date entered in the Delivery Date/End Date field falls within the date range you enter in the Date of Service fields on the report options window.

Line 2: Deliveries Performed by Health Center Provider

The number in Line 2 in Section A reflects all of those patients in your practice where there is an active pregnancy record where the date entered in the Delivery Date/End Date field (Figure 6.3 on page 6.3) falls within the date range you enter in the Date of Service fields on the report options window.

Remaining Lines of Section A

The remaining lines of section A pertain to the race and ethnicity of your prenatal patients and detail about their births.

Column 1a, Prenatal Care Patients and Referred Prenatal Care Patients Who Delivered During the Year

In order for the patient to be counted in Column 1a on this report, the date displayed in the Delivery/End Date field (Figure 6.3 on page 6.3) for the selected pregnancy falls within the date range you enter in the Date of Service fields on the report options window.

� The total in Column 1a will not equal the total of Column 1b+Column 1c+Column 1d. See page 7.2 for more details.

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Section B: Controlling High Blood Pressure Chapter 7. Health Outcomes and Disparities (Table 7)

Columns 1b through 1d, Live Births

To be counted in Column 1b through Column 1d, MicroMD PM must find an entry in the Weight at Birth field for the fetus entry on the pregnancy record. In addition, either Full-Term or Pre-Term must appear in the Description field at the pregnancy level of the record. MicroMD PM then adds to the appropriate column on the report.

You may be tempted to compare the total for Column 1a with the sum of Columns 1b, 1c, and 1d. These numbers are not related in this fashion.

Column 1b through Column 1d only considers fetus entries for pregnancy records where Full-Term or Pre-Term appear in the Description field while Column 1a also includes patients with pregnancy records for Stillbirth, etc.

If there is no entry in the Weight at Birth field on the fetus record, it does not count in Column 1b

through Column 1d, but the patient does count for Column 1a.

The patient only counts once for Column 1a, but each fetus record counts individually for

Column 1b through Column 1d based on Race and Ethnicity of the fetus record.

Section B: Controlling High Blood Pressure (CMS165v6)

The Clinical Quality Measure (CQM) reports on the “Percentage of patients 18-85 years of age who had a diagnosis of hypertension and whose blood pressure was adequately controlled (<140/90mmHg) during the measurement period.”

Section B of the Table 7 report mostly aligns with the CQM displayed in the heading to this section. The only difference is the UDS report stratifies the numbers based on race and ethnicity. See the Overview section on page 7.1 for details on finding race and ethnicity information.

Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details on how the system calculates each column.

Column 2a (Total Patients 18 through 85 years of Age with Hypertension): Use the instructions

for the Denominator in the CQM.

Column 2b (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column 2c (Patients with HTN Controlled): Use the instructions for the Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

○If you are a MicroMD-PM–only practice, the system pulls the hypertension data from your entries in the Clinical section of the Patient Detail window (on the Patient Profile Details tab).

�For MicroMD PM + EMR practices, the Clinical section of the Patient Detail window (on the Patient Profile Details tab) displays the patient’s most recent data. For details on meeting the measure, click the Clinical Measures Data button and scroll to the bottom.

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Chapter 7. Health Outcomes and Disparities (Table 7) Section C: Diabetes: Hemoglobin A1c Poor Control

Section C: Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9 percent) (CMS122v6)

The Clinical Quality Measure (CQM) reports on the “Percentage of patients 18–75 years of age with diabetes who had hemoglobin A1c (HbA1c) greater than 9.0 percent during the measurement period”

Section C of the Table 7 report mostly aligns with the CQM displayed in the heading to this section. The only difference is the UDS report stratifies the numbers based on race and ethnicity. See the Overview section on page 7.1 for details on finding race and ethnicity information.

Please refer to the MicroMD EMR Clinical Quality Measurement Calculations Guide: Performance Year 2018 for more details on how the system calculates each column.

Column 3a (Total Patients 18 through 75 years of Age with Diabetes): Use the instructions for the

Denominator in the CQM.

Column 3b (Charts Sampled or EHR Total): In MicroMD PM, Column B is the same as Column A.

Column 3f (Patients with HbA1c > 9% Or No Test During Year): Use the instructions for the

Numerator in the CQM.

Click here for a searchable list of codes used for this measure.

○If you are a MicroMD-PM–only practice, the system pulls the diabetic data from your entries in the Clinical section of the Patient Detail window (on the Patient Profile Details tab).

�For MicroMD PM + EMR practices, the Clinical section of the Patient Detail window (on the Patient Profile Details tab) displays the patient’s most recent data. For details on meeting the measure, click the Clinical Measures Data button and scroll to the bottom.

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Financial (Table 9)

The UDS Table 9 report in the system allows the practice to generate a report based on patient related revenue and collects information on charges, collections and allowances. You can find the report under Aux > MicroMD CHC > UDS Reporting Tables > Financial - Table 9 from the main menu. Table 8.1 explains the fields in more detail.

In This Chapter

In this chapter, we cover:

Report Options (page 8.1)

Overview (page 8.1)

Line 1 through Line 12 (page 8.2)

Line 13 (page 8.3)

Report Options

To generate the report, you must first establish your reporting criteria. Only patients who meet the criteria on the report options appear on the report. Table 8.1 explains the options in detail.

Overview

The Table 9 Financial report in MicroMD PM compiles information about the transactions posted against insurance plans based on the CHC Payor Category on each insurance plan. You can find this field on the Plan Detail window for the appropriate insurance (under Maint > Plan).

Table 8.1 Report Options Available for Financial - Table 9

Field Description

Date of Service Select the service date range for which you want to generate a report. The default date is January 1 to December 31 of the previous year. You can change this as needed.

Location From the Location drop-down, select the location(s) for which you want the report generated. MicroMD PM includes only those patients with sequences posted against the selected Location during the date range you specify in the Date of Service fields.

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Chapter 8. Financial (Table 9) Line 1 through Line 12

Figure 8.1 CHC Payor Category

Line 1 through Line 12

Lines 1 through 12 on Table 9 total the transactions posted to patient accounts where the Service Date on the transaction falls within the date range you enter in the Date of Service fields on the report options window. The system breaks the data into those transactions posted to insurance carriers associated with the indicated Payor Category in the CHC Payor Category drop-down on the Plan Detail window (Figure 8.1).

MicroMD PM determines the dollar amounts that appear in Columns A, B and D for Line 1 through Line 12 in the following manner:

Column A includes all transaction lines except those where the POS is one of the following:

AND the Bill flag for the transaction line is not set to N - Pat. Billing/Pat. Resp.

AND the plan’s CHC Payor Category field in not set to 13 - Self Pay

Column B includes transaction lines where the POS is P1 - PAYMENT CASH or PO - PAYMENT OTHER.

AND the Bill flag for the transaction line is not set to N - Pat. Billing/Pat. Resp.

AND the plan’s CHC Payor Category field in not set to 13 - Self Pay

Column D includes transaction lines where the POS is WR - ADJ TO WRITEOFF or W1 - WRITEOFF

AND the TOS for the procedure is II - INSURANCE - CHECK

AND there is a check mark in the Allowances checkbox on the Procedure Detail window for the procedure

� The sequence number for the sequence containing the transaction must be 1 or higher.

- P1 - PAYMENT CASH

- PO - PAYMENT - OTHER

- R1 - REFUND

- W1 - WRITEOFF

- PR - ADJ - REDUCE PAYMENT

- WR - ADJ TO WRITEOFF

- PI - ADJ - INCREASE PAYMENT

- RR - ADJ TO REFUND

- BI - BALANCE FORWARD - DEBIT

- BR - BALANCE FORWARD - CREDIT

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Line 13 Chapter 8. Financial (Table 9)

AND the Bill flag for the transaction line is not set to N - Pat. Billing/Pat. Resp.

AND the plan’s CHC Payor Category field in not set to 13 - Self Pay

Line 13

Line 13 deals with self-pay patients, and in MicroMD PM, the system totals any amounts that are the patient’s responsibility to pay and displays them in the appropriate column.

Column A includes all transaction lines except those where the POS is one of the following:

AND:

- the plan’s CHC Payor Category field is 13 - Self Pay and the Bill flag for the transaction line

is not set to N - Pat. Billing/Pat. Resp.

OR

- the Bill flag for the transaction line is N - Pat. Billing/Pat. Resp.

Column B includes transaction lines where the POS is P1 - PAYMENT CASH or PO - PAYMENT OTHER.

AND:

- the plan’s CHC Payor Category field is 13 - Self Pay and the Bill flag for the transaction line

is not set to N - Pat. Billing/Pat. Resp.

OR

- the Bill flag for the transaction line is N - Pat. Billing/Pat. Resp.

Column E includes transaction lines where the procedure code DOES NOT match the code

selected in the Bad Debt Writeoff Code drop-down on the Practice Setup tab (under Aux > MicroMD CHC > Setup > Practice).

AND the POS on the transaction is W1 - WRITEOFF or WR - ADJ TO WRITEOFF

AND:

- the plan’s CHC Payor Category field is 13 - Self Pay and the Bill flag for the transaction line

is not set to N - Pat. Billing/Pat. Resp.

OR

- the Bill flag for the transaction line is N - Pat. Billing/Pat. Resp.

Column F includes transaction lines where the procedure code DOES match the code selected

in the Bad Debt Writeoff Code drop-down on the Practice Setup tab (under Aux > MicroMD CHC > Setup > Practice).

- P1 - PAYMENT CASH

- PO - PAYMENT - OTHER

- R1 - REFUND

- W1 - WRITEOFF

- PR - ADJ - REDUCE PAYMENT

- WR - ADJ TO WRITEOFF

- PI - ADJ - INCREASE PAYMENT

- RR - ADJ TO REFUND

- BI - BALANCE FORWARD - DEBIT

- BR - BALANCE FORWARD - CREDIT

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Service Area Table

MicroMD PM UDS Reporting Guide: Performance Year 2018 A.1

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Tables 3a, 3b, and 4

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B.2 MicroMD PM UDS Reporting Guide

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MicroMD PM UDS Reporting Guide B.3

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Table 5

MicroMD PM UDS Reporting Guide: Performance Year 2018 C.1

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Table 6a

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D.2 MicroMD PM UDS Reporting Guide

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Table 6b

MicroMD PM UDS Reporting Guide: Performance Year 2018 E.1

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E.2 MicroMD PM UDS Reporting Guide

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MicroMD PM UDS Reporting Guide E.3

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Table 7

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Table 9

MicroMD PM UDS Reporting Guide: Performance Year 2018 G.1

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Henry Schein MicroMD760 Boardman-Canfield Road

Boardman, OH 44512

www.micromd.com

330-758-8832