Submission Process - Resubmission

Resubmitting One Case

After a submission is complete, you may receive an e-mail from a client requesting changes. As long as it is within the submission window, we make every effort to get the corrected data submitted.

1. Determine if the submitted case needs to be deleted prior to resubmitting a new file. The criteria for a unique record for IQR and OQR are below.  The only fields that would be able to be changed in ENCOR for Hospital Abstracted Measures are Admission Date (IQR), Discharge Date (IQR), Outpatient Encounter Date (OQR) or Arrival Time (OQR). If any of these fields will be updated, a delete file must be processed prior to resubmitting in order to avoid duplicate cases being created.

   1. IQR Unique Record Key (What fields make a record unique?)

      For each patient episode of care, the following data elements will identify the case as a unique record in the HQR Secure Portal:

      • CMS Certification Number

      • Patient Identifier (Medisolv Case Identifier)

      • Admission Date

      • Discharge Date

      • Measure Set

   2. OQR Unique Record Key (What fields make a record unique?)

      • CMS Certification Number

      • Patient Identifier (Medisolv Case Identifier)

      • Arrival Time 

      • Outpatient Encounter Date

      • Outpatient Measure Set

2. Determine the Medisolv ID(s) of cases being updated. 

3. Create delete files for these cases (just in case). This is done using Export Patient Data. The files should be sent to Subway for retrieval. 

4. Once this is done, unlock the Measure Set so the client can make changes. 

5. Once changes have been confirmed, relock the Measure Set.

6. Using Export Patient Data, create files for the updated cases. Send to Subway.

7. Depending upon #1 above, whether the case requires a delete or not - either submit the delete file, wait for processing to complete, then submit the new file OR if no delete was needed, submit the new file.

8. Rerun submission reports.

Claims are greater than submitted cases, more cases need to be added.

After a facility submission is complete, the PPR may reflect fewer cases submitted than there are claims. This situation is fine if five or fewer cases exist. If the number of claims is greater than five, the facility should be notified they may be missing cases.

1. E-mail the facility with the discrepancy and have them review the Medicare Claims Report on HQR for the measure set indicated.
2. If the facility states there are no cases they can add, request they reach out to Quality Reporting Center for guidance.
3. If the facility locates and wishes to import more cases, proceed with steps to get the file imports turned on (see Parameters - Number of Quarters to Process), Unlock Quarter for the Measure Set, and have them send JUST the missing case(s).
4. Once the cases have been imported, run the IPP Procs for the impacted Measure Set.
5. Have the facility abstract the case(s).
6. Once complete, Lock Quarter for the Measure Set, Save and Lock cases, perform pre-submission check for the new case(s).
7. Follow the instructions for Submission Process IQR/OQR - Medisolv Admin. You are essentially performing a brand-new submission for the facility for OQR or IQR. This decreases the risk of losing files by unzipping/rezipping and creates the population and sampling files, because these must be resubmitted, as well.