Data Validation - Educational Reviews

Hospitals-Outpatient

The Hospital Outpatient Quality Reporting (OQR) Program offers educational reviews of medical record validation results to those hospitals selected to participate in medical record validation. The deadline for requesting a review is within 30 days of the validation results being posted on the QualityNet Secure Portal.

To request a review, follow the steps of the Hospital OQR Validation Educational Review Process (PDF-154 KB) using the required Quality Reporting Validation Educational Review Request Form (PDF-152 KB).

For CY 2020 and subsequent years, if a hospital requests an educational review for any of the first three quarters of validation and this review yields incorrect CMS validation results for chart-abstracted measures, the corrected quarterly score will be used to compute the final confidence interval.
NOTE: The quarterly validation reports issued to hospitals will not be changed to reflect the updated score due to the burden associated with reissuing corrected reports. Due to the need to calculate the confidence interval in a timely manner, and the insufficient time available to conduct educational reviews, the existing reconsideration process will be used to dispute an unsatisfactory validation result for the last quarter of validation. If a hospital does not fail validation, the hospital still would have the opportunity to request an educational review within 30 days of receiving the results.

For Validation questions, contact the Value Incentives and Quality Reporting Center (VIQRC) Validation Support Contractor. Hospital OQR Program Questions/Answers can be found at the Hospital-Outpatient Questions/Answers website or call, toll-free, (866) 800-8756.

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