Negative Payment Adjustment Informal Review

If you think you are getting the negative adjustment in error, review the following to submit an informal review request:

1. Go to the Quality Reporting Communication Support Page (CSP)
2. In the upper left-hand corner of the page, under “Related Links,” select “Communication Support Page”
3. Select “Informal Review Request”
4. Select “PQRS Informal Review”
5. A new page will open
6. Enter Billing/Primary Taxpayer Identification Number (TIN), Individual Rendering National Provider Identifier (NPI), OR Practice Site ID # and select “submit”
7. Complete the mandatory fields in the online form, including the appropriate justification for the request to be deemed valid. Failure to complete the form in full will result in the inability to have the informal review request analyzed. CMS or the QualityNet Help Desk may contact the requestor for additional information if necessary.

For more information, please review the following document: 2017 Negative Payment Adjustment – Informal Review Made Simple