Once data is successfully imported for an ACO's TIN participant, numerators and denominators as reported by their EHR may be used as a comparison to what is reported in Patient360 at the TIN level. This provides assurances that the data is being imported into Patient360 accurately. 


Manual TIN Validation

This method of validation should be used throughout the performance year. 


1. Obtain TIN level scores from Patient360 

  • Choose the TIN participant Clinic in the Clinic Navigator 
  • Verify that you are in the correct reporting year
  • Select Group Practice > Group Practice
  • Select the practice's name in blue
  • In the Measure Overview Panel, make note of the Eligible Population (EP/Denominator), Denominator Exceptions (DENEX), Denominator Exclusions (DENEXCEP), Met, and Not Met.

2. Obtain TIN level scores from EHR following instructions by the TIN's EHR. Additional guidance can be found here. 

3. Compare scores from Patient360 with those found in the EHR. Numerators and Denominators should generally match Patient360 with a less than 5% difference. If there is a greater than 5% difference, contact support via the Patient360 portal and provide patient examples that are not matching between Patient360 and the EHR. 



TIN Validation using Validation Sheet 

This method of validation should be used once entire year of data has been uploaded to Patient360 in preparation for submission.


1. Obtain TIN level scores from EHR following instructions by the TIN's EHR. Additional guidance can be found here.

2. Navigate to the Validation link provided by Patient360 in the links section of the ACO Meetings Notes 

3. Choose the appropriate tab containing TIN level performance scores 

4. Enter performance from EHR for the appropriate TIN and measure under the column labeled EHR Comparison. 

5. The Difference column should reflect a less than 5% difference between the performance calculated in Patient360 as compared with the EHR reported performance. If there is a greater than 5% difference, contact support via the Patient360 portal and provide patient examples that are not matching between Patient360 and the EHR.


Collection Type Guidance

eCQM

To validate eCQM data, numerator and denominator scores should be compared to what is reported in the EHR.  Most certified EHRs accurately track both numerators and denominators and provide a straightforward way to perform this comparison. 


CQM

To validate CQM data, numerator and denominator scores should be compared to what is reported in the EHR if possible. If the EHR is not keeping track of the required measures, a random sampling of patients and encounters should be taken and found in both the EHR and Patient360 portal to be compared. We recommend reviewing a sample of 25-50 patients. 


mCQM

If the EHR supports measure counts for Medicare beneficiaries only, numerator and denominator scores should be compared to what is reported in the EHR to validate mCQM data. If this is not possible, a random sampling of patients and encounters should be taken and found in both the EHR and Patient360 portal to be compared. We recommend reviewing a sample of 25-50 patients.