1. [Practice Name Here] [Tax ID# Here]
ACO Logo Here

2. Automated API Submission
ACO MACRA Roadmap Coordination, management, education for Community Clinics
MACRA Concierge
At year end, we hold several virtual meetings with each practice to educate on MIPS, then obtain, optimize and actually submit their PI data.
Our sharable dashboard tracks progress across all TINs, while updating overall ACO performance score.
As a result, we will be provide excellent advance predictions of your expected MIPS financial adjustments.
Automated API Submission
Throughout this process, you will have access to a MACRA concierge, knowledgeable in all relevant CMS regulations, and dedicated to optimizing your MACRA scores. Higher MACRA scores = Higher Medicare Revenues!

3. Year-End PI Data Acquisition
2018 PI measures are the same as 2017 ACI measures. You will not need to log into QPP or do any other submission activities. You will need to provide us with data from your Certified EHR – and every Certified EHR has the capability to generate this data. Your reports should be provided at the individual physician level where possible. We will perform the group level aggregation, and automatically submit your PI Data.
Most common data formats are:
QRDA-3 (probably new since last year, but we find that very many EHRs have this. It is the easiest, quickest, and most accurate method)
CSV or Spreadsheet report (The spreadsheet must contain, for each physician, each measure with its numerator and denominator values).
PDF or Scanned Paper (While rare, we occasionally have to work with paper / PDF reports from your system. In the event you cannot generate QRDA-3 or CSV, we will use your reports to manually enter data into our system, and prepare your data for automated submission.)
Your MACRA Concierge will be available at any time to help with PI Data reporting, analysis and even in suggesting actions based on the data we receive. If you don’t know how to get reports from your EHR, or if the reports you are getting are inadequate, we will work together with you and your vendor to retrieve the necessary data.

4. CPIA and CQM Data Acquisition
CPIA: For most ACO’s, CPIA is not necessary. In the event you need them, MACRA Monitor will help manage your CPIA selections. Once you have documented these selections, we will automatically submit them. Your Concierge will provide the appropriate guidance to you.
CQM: There is no need for you to submit CQM data for 2017, since the ACO will calculate and submit CQMs based on your claims history. Starting in April of 2019, we will provide an option for monthly analysis of CQMs, using data from your EHR. We will provide more information on this process at that time.
Your MACRA Concierge will be available at any time to help with CPIA and CQM Data reporting, analysis and even in suggesting actions based on the data we receive. If you don’t know how to get reports from your EHR, we will work together with you and your vendor.

5. Yes / No Assertions
Note that not all data required for success under MACRA will come from your EHR and/or Registry vendors. The following list contains your assertion of compliance with these items.
Please initial asserting each of the following yes/no Attestations that indicate your agreement:
______ We have completed a Security Risk Assessment completed in Calendar Year 2018
______ We agree to Prevention of Information Blocking Attestation
______ We agree to ONC Direct Review Attestation
______ We are actively engaged with or submitting Immunization Data
______ We are actively engaged with or submitting Syndromic Surveillance Data
______ We are actively engaged with or submitting Specialized Registry Data
Please print this page, scan, initial the relevant attestation, and submit to your Concierge

6. Attestation Authorization Signature
As a Health IT Vendor defined in the MACRA regulations, C3 Partners / MACRA Monitor submits MIPS data to CMS in conjunction with your staff, CMS requires that we obtain your written permission to do so. In order to automate your submission, we follow “registry” submission guidelines. These guidelines allow us to submit data without your need to log into QPP / EIDM.
For practices choosing the MIPS Individual Reporting Option, this consent must be signed by all MIPS eligible clinicians for whom Individual submission is being done.
For practices who opt for the MIPS Group Reporting Option (almost all ACO members), this consent may be signed by a proxy. The proxy will assume the responsibility to provide MACRA Monitor with a roster of Individual NPIs linked to the practice TIN. The proxy agrees to inform the applicable clinicians in the TIN that their MIPS data is being submitted to CMS on their behalf by our Qualified Registry, using the MIPS Group Reporting Option.
Random documentation audit on CQM Submissions: If we are submitting CQM data on your behalf, some of your providers may be required to provide data that can be used to validate the CQM calculations. Please note that no PHI is required or accessed, unless a provider is selected for random audit. We are required to select 3% of all TIN/NPI combinations we submit (across our entire client base) for random documentation validation. If a provider is selected for random audit, we will require at least 25% of the selected provider’s patient encounters, in a standard data from your EHR on provider, patient and clinical activity. Any such data will be at the patient level, but can be de-identified. The intent of this audit is to verify that sufficient documentation exists to support reported measures, and will not result in any reporting to CMS. No measure values will be updated as a result of this audit.
The undersigned authorizes C3 Partners, LLC to attest MIPS data (ACI, CPIA and CQM data as applicable) to CMS as a surrogate or proxy, and agrees to provide patient and clinical documentation supporting quality measures, in the event a provider is selected for random documentation audit.
Organization Signature Printed Contact Name Date
_______________________________ ________________________ ________________________________ _____________
Please print this page, scan, sign, date, and submit to your Concierge