Frequently Asked Questions

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FAQ

Can I use my Accountable Care Organization’s (ACO’s) claims data to submit documentation for a quality validation audit?

No. Documentation must come from the beneficiary’s medical record and document the care provided (with the exception of prepopulated claims data for Prev 7/ACO 14). For all other measures, medical record documentation should support the data your ACO reported in the CMS Web Interface in order to successfully meet both the reporting and the audit requirements.
(FAQ18541)

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