rateMAX 101
This SharePoint site contains official measure training material
What is: Education and Training Resource Center
Adequately controlled blood pressure reading
What is: <140/90 mmHg
The provider types considered appropriate for completion of medication reconciliation post discharge
What is: RN, physician assistant, prescribing practitioner, clinical pharmacist
907A_169335201PC
What is: Member ID
The 3-letter abstractor value for internally abstracted records
What is: MDC
Facets, Maestro, ISET
What are: Claims Systems
MY2025 Triple Weighted STAR Measures
What are: CBP & GSD
There is no provider type requirement for this sub-measure
What is: Patient Engagement after Inpatient Discharge (PED). PED does not require a provider type, and the visit does not have to be related to the discharge, or the diagnosis associated with the admission.
Members who die within the MY
What is: Required Exclusion
Internally abstracted charts are viewed using this platform
What is: OnBase
Review non-compliant members to identify and pursue compliance opportunities
What is: rateMAX
Less than or equal to 9
What is: Compliant HbA1c/GMI
The practitioner responsible for the member's care during the inpatient stay, procedures/treatment provided, diagnosis at discharge, current med list, testing results, & instructions for patient care post-discharge are required components for this sub-measure
What is: Receipt of Discharge Information (RDI)
All records/documents uploaded to an OnBase folder must be in this format
What is: PDF format
An abstraction correction is identified during an over-read. The rateMAX is put on-hold using which 'OnHold' Reason
What is: Pending Vendor Review Feedback
This sample status abbreviation represents a compliant sample member based on collected medical record data
What is: Sample status CM
Bathing, dressing, eating, transferring, using toilet, walking
What are: Activities of Daily Living (ADL)
In a shared EMR, the Care Timeline with the date of admission noted is acceptable for this sub-measure
What is: Notification of Inpatient Admission (NIA). The Care Timeline is updated in real time and can be assumed that the information was available to the PCP/OCP on the date noted.
OnBase Unique ID that begins with 444
What is: Internal Chart ID
Two primary reasons to submit a QOI Request
What is: When an abstraction error is identified or evidence to exclude a member has been missed.
Box 25 on standard claim image
What is: Federal Tax ID Number (TIN)
BP readings taken during an acute inpatient stay
What is: Unacceptable documentation for the CBP measure.
A standalone current med list without evidence of review or reconciliation does not meet compliance for this sub-measure
What is: Medication Reconciliation Post Discharge (MRP)
Skilled Nursing Facility (SNF), Memory Care, Assisted Living, Rehab Center, Nursing Home, LTC Facility
What are: Non-Acute Facilities
When accessing a chart in a vendor system the specialist must assess this Unique ID (assigned from QMRM) and ensure it matches rateMAX
What is: HRChase ID