TheraOffice .13 Update & Additional MIPS Measures

February 18, 2019

Hosted By:

Nick Austin

Welcome everyone to today’s webinar on the .13 MIPS update. This update is very very targeted towards myth specifically. So hopefully everyone in attendance today is at least in some capacity paying attention to me oops because I think all but one slide or dedicated just entirely too Maps, so.

Yeah, hopefully that’s you guys are here for is going to be a pretty quick webinar pretty quick and direct to the point updates that were made to this version. So we should be able to get this pretty quickly and get over to questions. So let’s go ahead and get started. That’s a real quick on the agenda.

Here’s pretty much what we’re going to be going over. We’ll talk a little bit about mips timeline and some development in sight get your guys feedback on how we’re kind of approaching this then we’re going to go over the two new sets of measures that were included in this update for Falls and diabetes talk about how you cannot select which measures you’re going to be reporting on.

Quickly touch base on some of the other dot 13 changes that went into this update mostly fixes, and then also talk about the qpp participation lookup tool available from Medicare.

Alright, so first off I wanted to a little bit touch base on some development inside kind of get you guys into our perspective and understand kind of why we’ve approached nips and the way that we’ve done this year. So there are really two ways of kind of handling nips measures within any EMR. The first method is the attestation method and this is the the way that we approached pqrs back in the day.

Basically, what it is is I attest to documenting X there for completing this mips measure you would simply make Etta stations as to whether or not you did something in other parts of your documentation by doing so we would assume that those at her stations are correct in this approach towards the quality measures.

We are very flexible. We can add measures very very quickly because it’s a simple kind of adding to a database record for those the downside to doing this attestation method is that it is sometimes confusing for the user and sometimes not fully compliant. You might have test to doing something but then you didn’t actually do it.

So you see this inconsistency between what was reported what was actually done. Giving kind of our experience with Peter S. We decided to take a different approach towards the mips program and that’s approach number two, which is the documentation method. So I documented X therefore completing this nips pleasure.

This is more time consuming for us to develop because. We’re actually creating specific sections dedicated sections for each of these measures, but we feel it’s easier to use and we feel like it’s a more compliant because we know for certain that you’re doing what’s required to fulfill that measure so we went with option number two for documentation.

And if you’re in today’s webinar because you’re participating in mips, that means you probably already been using these measures to some degree in the first two months of the year. So, If you guys have any feedback with regards to. These two different approaches if you like the new approach compared to pqrs if you prefer the old approach because you thought it was easier.

We’d love to hear your feedback on that. So feel free to use the Q&A panel to let us know kind of what your experience has been so far for our event unfortunate looks. Pete mips might be around for a little while and every year is kind of operates independently of each previous year. So we want to hear your feedback on this.

We know the kind of the correct way of approaching this moving forward for everybody so far. We think the feedback has been positive, but would love to hear from you guys directly. So given that different approach. I want to talk a little bit about the timeline. So you guys can understand why these Falls measures are coming a little bit later than they were before.

So back on July 12. They did a proposed rule for physician fee schedule where in that proposed rule they said pts and OTS would be included and they also indicated that the old falls measure would be merged and doing new Consolidated measure. Okay, so we assumed that we would have to get that one included and then when we got to the final rule on November 1st, they simply said we’re removing the Falls measure from the 2018 reporting Year.

We’re not consolidating it. It’s gone. There was still no trace of the old measures still be included in the specialty set and given that given that it wasn’t available given that the measure specifications weren’t available for that year and how. What has changed what hasn’t changed? We just kind of didn’t know at that point.

We proceeded with the ther office web dot 12 version being released and that did not include the Falls measure of this was released on December 13th, and it wasn’t actually until December 27th that we got the measure specification documents and it indicated to us for certain that the old falls measure could be reported on so unfortunately this.

Is a consequence of kind of that documentation method that we decided to go with where the Falls measure ended up coming in late? And now that being said the sixty percent reporting threshold for each of the measures means that you will still be able to report on these Falls diabetes measures. You can still score a hundred percent on those individual measures.

As long as you’re reporting 60% your patients on the year, so it’s okay that they’re coming late. But we do wish we could have gotten them in earlier. So again, it kind of goes back to that attestation first documentation method. How are you guys just feelings on what is the better approach towards that love to hear that feedback on it.

So without further Ado though, let’s kind of go over the falls measures now and how those are going to be introduced into TheraOffice with this next update. All right. So the Falls measures we talk about Paul’s it’s really two separate measures. So you get kind of a credit for two of these when reporting and those are Falls mayor 154 all risk assessment and then 155 plan of care.

This is for PT and OT. It’s for evals Andrea Val’s claims and registry. So in all those options something different about Falls is that it is for only patients 65 years or older. So patient must be 65 years or older. Most of the previous all the previous measures that we were looking at were all 18 years or older.

This is 65 years or older. It’s still all insurances. Every insurance but really this ends up just being the Medicare because it’s 65 years or older. Another thing that’s slightly different about this measure is to report these measures on a patient. The patient must be at risk for Falls defined as documentation of two or more falls in the past year or any fall with injury in the past year.

Okay, so that’s what you have to be at risk for Falls to even report the measure for a patient. So let’s look at how we handle that within TheraOffice. So just like the BMI you’re going to have a dedicated section for the fall to the two Falls measures. And this is what that new section look like looks like it starts with.

The top question of has the patient had two or more documented falls in the past year or any fall with injury in the past year if you answer no to this question because the patient is not at risk for Falls, then you cannot report this measure for this patient. There’s no denominator exclusion.

There’s no anything you simply cannot report this measure for this patient if they are not at risk for a fall. This is a little bit different than what we’re seeing with other. BMI measurer and pain and function in that this measure in particular like that is a requirement to even be part of the denominator and I don’t want to get too deep into the discussion of how this scores again.

But essentially that’s the first requirement and he can’t even go any further without that being satisfied. But once you actually do click yes to satisfy that one the rest of the sections within Falls will open up to you and you’ll be able to check off for Falls risk assessment completed Falls risk plan of care completed and then you get your additional notes for documentation, even though a lot of those Falls documentation gets completed in other areas.

If you did need another area to indicate it you would do it through there. And then you also have your reasons for not completing a risk assessment defined by Medicare that you can check off to exclude the patient. If it’s not a relevant question for the patient example of that the patient’s wheelchair-bound but they did have were at risk for falls in the past.

They would be considered as a nominator exclusion because you wouldn’t be able to do the risk assessment and plan of care for. Also based off of previous midsections kind of feedback and questions that were receiving from those. We took a little bit. Took a liberty in that we added some documentation right from those measure specification documents right within the section.

There was a little bit of a lack of clarity in the previous sections on some defining points. So we thought it would be better if Within These specific mips dedicated sections that we would actually tell you exactly what the definition of these terms is so the risk assessment the plan of care the exact documentation coming from Medicare is is listed there.

And we do the same thing with the diabetes sexually. So the big question kind of ask yourself with regards to the falls measures are will you be able to meet that 20 patient threshold for the year? You’ve got a report on 20 patients and to report on this measure you have to have a patient that actually has a risk of false.

So that is that’s the biggest downside to the falls measure in that you’ve got to be able to move that threshold. And this also does introduce a new benefit towards group reporting because if you’re doing group reporting, you have to beat that 20 patient threshold across all of the patients that you’re doing the group reporting for individual.

You have to meet that 24 that individual provider. So that’s a big thing with regards to the false. But that will talk a little bit more in a few sections here. I’m how you would start to utilize those Falls measures should you want to.

Alright, so the next set of measures that we included in this update where the diabetes measures and this is measure number 126 diabetes mellitus diabetic foot and ankle care peripheral neuropathy neurological evaluation. And then I apologize. Didn’t complete the rest of it, but the then there’s the other diabetes mellitus one as well for 127.

You’ll see that more in the next section with the screenshot. This is for PT only and for evals Andre Val’s and this is registry only. So if you are claims reporting you will not be able to report on either of these measures. You’ll start seeing that more and more as we expand in the more measures and more things become available for PTS.

A lot of the all the outcomes measures really require registry reporting any measure that requires two points of data across two dates of service are going to require registry reporting. So if you are doing claims it keep in mind that the there will also be a limiting number of measures you can be reporting on that as this program kind of continues to expand.

This one is patient must be 18 years or older. So any patient over 18 the big catch on this one. Is that to report these measures on a patient the patient must carry a diagnosis of diabetes mellitus? Okay. They must actually have that diagnosis code in the case what we’ve noticed as we’ve kind of been doing the research on this is that a lot of people are.

A lot of patients that might be diabetic do not have the diabetics diabetes diagnosis code actually in their case. It didn’t come over from the referral and because of the specificity of ICD-10. You’re not diagnosing it yourself.  In order to report these measures that diagnosis code has to be in the case.

Okay. So here’s kind of the approach that we took towards handling that specific section. The first thing just like the Falls measure. The first thing at the top of this section is a check diagnosis button. And when you click on this button, it is going to look in the case for this document and see if any of the ICD-10 codes are for diabetes.

If they are then the rest of the sections will enable if they’re not it’s going to give you a prompt saying the diabetes diagnosis code must be in the case. So you might have to be contacting the referring physician. You might have to get that information have a process for getting that information for diabetes patients.

If you’re going to be reporting on this measure that diagnosis code does have to get in the case in order to report this one. But let’s say you did check it and diabetes code is in the case. The rest of the sections will enable and you’ll be able to check the boxes for whether or not you did the neurological exam and whether or not you did the Footwear evaluation if patients not eligible.

You can check those boxes and then you have your additional notes or the in an eligibility reasons available document. There as well again neurological evaluation and evaluation of Footwear will both appear at the bottom automatically calculate it out for you the same rules apply in terms of 20 patients grouper single or individual.

You got to make sure that this is report on for 20 patients, which means you have to have 20 diabetes diagnosed patients. That you filled out this form on in the year to be able to report on if you fall short of that 20s and your registry customer essentially what that means is we just won’t be able to include that in our reporting to Medicare.

So yeah, it’s both our are not as easy slam dunks is kind of the others in terms of they apply to everybody. So those thresholds don’t matter to you in these it is a little more detailed in terms of the requirements.

Okay, so time for a quick poll. So with regards to this update when you update to the top 13 version, which I know a lot of our web customers have already updated. You will not receive these two new sections automatically. You need to essentially let us know so that we can run a script to manually get that information in your documentation.

The reason that we are approaching it this way is because we want you guys to let us know when you’re ready for it. Because if we load that in and somebody is still on a previous version they will not be able to lock their notes so we can only. Load in the falls and diabetes sections once everybody on your database has updated.

So if you are interested in getting the halls or diabetes sections included in your documentation, please indicate. Yes through this poll. That doesn’t mean immediately. It just means we’re going to be following up with you on additional instructions in order to get you upgraded. But if you’re interested in either of these sections, feel free to just.

Answer this poll. And if you answer yes, you’re going to be receiving some follow-up information. You’re answering. No because I talk you out of it with all of those extra rules that go into these two sections then feel free to answer. No, but this will basically be our method of following up if you change your mind you answer no now, but you change your mind.

Yes later because contact support will be happy to help you again. This doesn’t commit yet admit to anything. This just gets you the follow-up email that we need additional information. All right. So with the introduction of these for new measures, we have a new problem that we didn’t have before in that previously.

We kind of just assume that if you are participating in mips that you’re participating in all of the available measures because we only have 400 in this case now, we are up to eight measures available within TheraOffice and that means that there’s going to be. Some people that want to report on all eight or collect data on all eight, and that allows us more flexibility when we go to report to Medicare and some people might want to.

Dictate which of those six that you’re going to be reporting on and leave it to only those six and not extend out any further. So in our mips participation tool available from administrator where it lists out, which providers are actually participating in the program, there’s now. Check boxes for each of the measure numbers in terms of which ones they will be reporting on the existing for that were in the system previously are automatically going to be checked for everybody following the update and the new for.

Sir, 126 127 for diabetes 154 and 155 for Falls those will be unchecked. So in addition to running the script to get those loaded in you would also have to update your mitts participation to indicate which specific measures you’re wanting your providers to be collecting data on. Again, you can pick 6, you can pick eight.

You can pick for it’s up to you guys. I would probably say that I would. I would either do the six or the eighth option. I would definitely get try to aim for 6 and if you feel like it’s not very intrusive to include all eight, then go for that some things that some people might want to do is if you’re doing group reporting and you feel like you’re going to be able to get the total number or you’re going to be able to get those 20 patients for Falls and for diabetes.

You might want to think about. Stopping collection on current medications or BMI just because they’re Hassle and you don’t really want to report on them, you know, it might be easier for you just to exclude those. So we now give you kind of that flexibility right through that much participation wizard where you can control which actual measures are going to be reporting on.

Alright, so some other top 13 changes mostly fixes will go over these real quick. Some of you might be familiar with some of these and be happy that they’ve been changed. Some of you might not be not might not know that they were there at all. So first we fix an issue where the enter key in the grid would move you the next column instead of the next row.

We had to basically update all of our great controls and this last update and we apologize but it did leave left a few issues and I believe those all should be fixed. Now if you guys are still having any problems with any of those quick controls, let us know. The other issue that we had in there was it was causing text to be deleted from grades within the document editor when typing multiple lines into one cell.

So if you’re in say the settings section of the treatments we were seeing some some issues occasionally appear with that. We also fix an issue that would cause the evaluation complexity wizard to default to low-complexity after answering the first question. We fixed an issue that was causing the no-show appointments to still show on the schedule when it was set to hide.

This was web-only. Fix my shoe the prevented borders from being added to grids within the word processor web-only and lastly fix an issue that was causing the appointment reminder emails to be sent with the incorrect date in the body of the email and that again was web only.

Alright, so the last thing we’re going to go over today is kind of outside of TheraOffice, but we thought we’d share the news in case you weren’t aware but the qpp participation lookup tool from CMS as now gone live. For the 2019 reporting here. So if you’re not familiar, this is the tool that you can look up to see whether or not you are eligible or required to participate in mips.

We had this problem for the last several months of. The tool simply wasn’t updated for 2018. So we had no data as to who was required or having to use some reporting mechanisms within TheraOffice to find that data happy to say that that tool has been updated it got updated a little bit ahead of schedule from what our expectations were, which is great news if you’re participating in mips.

You know, if your group only it’s up to you whether or not you want to look up each one of these individual providers, but if you had any sort of we’re unsure about who is required. If you want to require, I would a hundred percent recommend running this tool against all the apis for your company each of the individual providers.

And this is going to give you concrete data. I would use this over our report or report doesn’t matter From medicare’s perspective. This is the tool that I would use. We have been running this against some random. Npi’s and comparing them to kind of what was collected in Fair office on that report.

We have seen that it’s been mostly consistent with a few a few random occurrences of it being slightly different. There’s also been some occurrences of it being wildly different. We saw one provider where they were actually required by TheraOffice and then a group only according to the qpp participation lookup tool we think that was because they.

The user renamed the provider that that was what I was from instead of deleting the provider and adding a new one. They just renamed an old provider. That’s why the data was was so drastically different between what Medicare was saying what we were saying basically if you’re participating in mips, I would definitely go use that tool and find out kind of where everybody stands with it.

There are some additional information within that tool that you should find helpful. You can actually see the special statuses of your clinic. So if you’re considered a small practice, you’re going to be able to see that from the tool here. I’ve got some screenshots of kind of what you end up seeing on that participation lookup will tell you directly what you’re reporting requirements are.

Your options whether or not you met each of the three thresholds, if you were Miss eligible clinician type which everybody should me and then the special status is all appear those below. So the rural small practice patient facing all of those things are available right from within this tool. So again highly recommend if you’re participating mips takes time run your empty eyes through there see where they stand with everybody.

You should see pretty consistent data between. What you’re seeing the report, but just to be safe. I would double check that.  All right. So I told you guys it was going to be a quick webinar today only had basically this update was entirely related towards us getting mips update and kind of fixing some in a few issues.

So happy that you guys could attend today’s webinar. I know we’ve got a few questions already in but feel free to get those questions submitted and we’ll make sure to get to each of them today. So I’m just going to take a few minutes here to read through what’s already been sent in?  All right can get to a few of these questions now.

So first one is I just about five minutes late, but want to know if we’re still if we still have to use pqrs for Medicare patients. So basically the old pqrs program. I think I probably dropped the phrase Peak dress in the webinar, which may be alerted some people to if that is still a thing that’s running parallel to this program.

Basically what they did to create the mips program was they rolled pqrs into Mims? So it’s the same program. In a lot of ways and it’s just roll directly into the mips program. So pqrs and of itself separate from everything else is no longer a thing. So you might be having a participate in mips. If you’re brand new to it.

Definitely recommend the previous webinars and to use that participation lookup tool to find out whether or not your individual and Pi is we’re going to be required to participate in the program. I would definitely start there. See whether or not you’re required and also attend the previous webinars to see if it’s going to be beneficial to you for you to participate.

Next question. How do I verify that all computers in the clinic is upgraded to the newest version? So the way we’ve structured the new update manager actually shouldn’t be a problem because you essentially have to allow for. The update and then once you push the update to the rest of your company, it automatically updates busy and give anybody a choice not to update that being said we still wanted to be cautious on this in case something was anybody was on a super old version.

What I would say is if a provider happens to be on an old version of the client and that is purely by mistake. It’s not intentional. They just happen to be on that old version. And you were to install the the falls and the diabetes measures. They’re just going to be prevented from locking the know they’ll receive an error and then you’ll update that client.

You’ll be fine. The main reason there’s some people that are purposely keep their versions Health back. Usually this exist in large company is we’re updating the version It’s like a. Turning a large ship essentially it’s harder to update for them. That’s the main reason that we’re kind of taking this approach in that some of those might not be ready to update across the entire company, but for the most part if you’re ready and everybody should be updated that should be enough for you to install the falls.

Okay. Next question is would it be a good idea to add or remove measures once we get feedback from Tio after the first quarter or will it be too late by then? It will not be too late. You can definitely add or remove measures based off of that feedback. You can control this throughout the entire year as to when it is that you’re requiring I would say given, you know, use the 60 percent reporting threshold is.

Sort of a gauge for when you would consider it to be too late. Obviously. You don’t want to be right at 60 percent and you want to account for seasonality if that’s going to impact your clinic but 60% of your patients need to be reported to Medicare. So what I would qualify as too late would probably be April or May but you should be good with in March to still make that decision again, if you’re leaning on the side of collecting it for those measures get them enabled now and your fingers are collecting more data.

Alright next question if all of our providers shown on eligible, but the group is eligible. Is it mandatory to participate the answer to this is no that’s something if I were to give a comment to Medicare with regards to how they’ve structured this program. I think they maybe need to add a little bit of clarity in this one that whenever you look up group or basically whenever you look up the individual NPI.

You’re going to get the group details for the the facility as a whole and it’s going to tell you whether or not the facility of the whole meets the thresholds and that doesn’t impact the individual. That’s only if you decide to do group reporting. So in this, you know, it’s a short answer is no if your individual provider is not required and you’re not doing group reporting and that individual providers would not end up being required.

Next question. Is there a way for the front desk to add in the BMI and weight when entering the patient’s chart we are looking into this in terms of a way of streamlining that process. Okay. Next question. Is it just kind of clarification on Photo the photo measures and whether or not this could be lies within the TheraOffice registry.

So yes, they can basically the requirements to report on the photo measures within the TheraOffice. The TheraOffice registry is to utilize the TheraOffice photo integration. If you’re utilizing that integration, we’re pulling information into our system enough to know or to to qualify those measures.

I will say that what one thing to note on those measures is that it requires both a an initial. Status and a follow-up status. So if you have any patients that you’re wanting to include in the photo measures know that those patients will have to have a distinct follow-up status done for them.

Basically. The way those measures work is that they are the difference between when the patient first came in and the. Most recent status after the patient has been discharged or most recent status up until the patient’s been discharged what that means is that you have to have a patient come in for the first one and then they have to have a compared comparison status that we can actually gain the results of whether or not they improved or didn’t improve so we need both of those statuses imported within TheraOffice.

And with that information. We will be able to calculate out the rest of it. Okay. Next question is how do you handle situation? If you have a patient that is being seen for a neck problem, but they reported two or more false. If our order does not have this diagnosis. We cannot treat what we do not have an order for the referring physician would wonder why he is getting his information when it is not what he saw the patient for.

So there’s kind of a few things on this. So the Falls measures do not require a any diagnosis code, but they do require essentially that history of Falls now if they have a history of Falls, but that wasn’t actually what they were sent for in any way. You can still report on that measure. Okay, even though that’s not exactly what they sent was sent for because that patients at risk for Falls.

You can be reporting this measure because it’s part of the mips program and that that’s that’s you know, you can make that decision in terms of what the referring physician is getting. They actually made the decision to not include a lot of the mips. Information on the generated report that you would send out we have that information available.

So if you did want to get it added to the report that is an option and we have had some people contact us about them. But the way we kind of felt was that the generated report was for the referring physician and he didn’t always. They didn’t necessarily essentially need to know the exact results of the mips measures that were being reported on that was something more for Medicare and more for a logging from within TheraOffice.

So by default wouldn’t actually see anything with regards to the falls measure on is generated report you could if you wanted to but we kind of felt like that wasn’t information that actually need to be generated on the report. I would say that that is debatable and that’s something that has been discussed internally and and with customers we do have the option for both for anybody that is that is interested.

Okay. Next question. Is it required to document on six measures for every patient? What are the eight measures available by TheraOffice? So. It’s not required. But if you want full credit in the program, you would have to report on six measures. What are the eight measures available within TheraOffice?

We’ve got two Falls to diabetes pain assessment. Functional assessment and BMI and current medications. So those are the eight that we have available and then you guys can pick from those which six you want to report on or you can pick all eight. And then that just more data to decide which measures we actually run a report to Medicare if you’re a registry customer.

Okay, next question. What if we’re looking up or providers in pi the provider doesn’t show eligible for individual or group I notice that there is an opt-in eligible as individual and group any advice. So I would look at the thresholds for each of these if your individual provider. Does not exceed any of the thresholds and your group doesn’t exceed any of the thresholds then I imagine there’s one of two things either you’re very new clinic or the way in which you’re reporting to Medicare.

You might be reporting it like the facility level instead of the individual level because basically to be eligible to report as a group your clinic would have needed to had 200 units. Billed to Medicare in the previous year’s termination period so I would think that that’s pretty atypical for your specific situation.

If you want to send us support an email with that NPI that you’re looking up will be happy to assist in kind of that decision process as well.  All right. So next question is what are the tests for the diabetes measure so there’s not specifically tests. What if we here actually, let’s go back to the diabetes section so we can kind of explain this a little bit better.

Okay, so basically within the diabetes measure if the patient is diabetic, they would be eligible for the measure and then the two measures themselves are a lower extremity neurological exam and a footwear evaluation. Okay, and then you’ve got each of the descriptions here the lower extremity neurological exam consists of documented evaluation of motor and sensory abilities and should include and then it kind of gives you some of the ways in which that would typically be tested.

There isn’t a specific functional test that goes into the functional testing section that clarifies it this one they pretty much just. It’s a neurological exam and then give you some examples and then leave you to it the same thing with their there with the Footwear evaluation. So not a specific test.

It’s more of how you would treat in each of those instances.

Okay, next question if we select a new measures and the P he is not qualified for the measures. Will you will you be allowed to lock the note and are sorry I think this patient that Petey so if the patient does not qualify basically what happens is when you go to lock the know. We’re going to tell you whether or not you’ve checked the diagnosis and we’re going to tell you whether or not you think the cated yes or no on the risk of Falls and for the Falls measure, you’re going to have to indicate no for each patient.

That’s over 65. So if they’re over 65, you have directly indicate. No within that section or academic block them out, but once you’ve indicated no that’s going to clear it and they’re going to be able to proceed with locking them. Okay, next question. Can you clarify the individual therapist need to do anything to report on diabetes in terms of like the diagnosis code you would need to get the diagnosis code in there and that code needs to come from The Physician that is a problem with the diabetes measure.

It’s an issue in terms of how the diagnosis codes get into our system and that you’re having to enter them in from whatever referral it is that you’re receiving if that referral does not include the diabetes. Diagnosis but that patient is diabetic. Then you need to get that information in order to proceed with the measure.

It is a valid valid problem with this measure and it’s something that we internally debated whether or not to include the diabetes letters at all given that we weren’t confidence that died or diabetes was actually getting diagnosed frequently. But once I diabetes diagnosis actually in the case, then essentially you just follow the descriptions here in terms of what.

Those evaluations would be about them. Not a pts. I can’t talk about the specifics of doing those tests. But basically once you’re treating for those two things that would be able to complete those measures. So you should see there should be enough information there to be able to know what needs to be completed for each of those measures.

Okay, next question in the next Fall’s situation how we be able to lock the note if the POC for Falls is not completed with they have to have the patient fill out the forms and do the fall assessment even if that’s not what we were treating. So basically for the fall section here, let’s jump back to the falls.

Okay. So for this fall section, the first question is yes or no whether or not they’re at risk for Falls and if they are not at risk for Falls the rest of it Gray’s out you don’t need to do anything if they are at risk for Falls. Then you were then eligible to do a Falls risk assessment or a false plan of care are and or a false plan of care and then by completing those two things you’re able.

Report for that patient. So it really all starts with the yes or no question of if they’re at risk for Falls and if the answer is yes, then this measure becomes available for that patient that doesn’t necessarily that you mean that you need to include all this information. If you’re not in the strict environment where we’re going to force you to report on each of these what we will force you to do for these measures or for the Falls measure.

Is indicating yes or no on the Falls risk on whether or not they’ve had documented falls in the past year. That’s the part that does need to get filled out if you’re going to be reporting on this measure because that’s how we know whether or not this patient should be included in the denominator of the scoring.

So hopefully that answers at the other thing is if if you’re interested, you know, there’s also the measure spent the full measure specification documents that really go into all the nuance and detail of these measures and a lot of reasoning that goes into them as well. And those are publicly available.

If you’re wanting more information on the diabetes measuring exactly, you know what it is that they’re looking for in terms of evaluating that patient and and treating them for it. We can we can send that over all that information is easily available. So just let us know if you are interested in more detail on either those measures and we can provide.

All right. I’m going to give it about two minutes more for some for any additional questions to come in. There are I think to hear that we’re going to follow up with directly. So if we didn’t answer your question, we will be following up after but let me get in about two more minutes here and then we’ll see if anything else comes in.

All right. So it looks like that’s about it for questions. I think we got a few follow-ups to directly thank you everyone for attending today’s webinar. Hopefully Vice guys found this valuable. There’s definitely a lot of interest in the Falls measures will be doing a follow up with you guys in terms of getting these installed and kind of all the instructions on.

And what additional information that we need in order to get this loaded? So thank you again for everyone for attending today’s webinar. Have a great day and let us know if there’s any other way we can have a good one. Bye.

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