MIPS Survey
Welcome to the Merit-Based Incentive Payment System (MIPS) Survey
1.
Please complete the following information:
(answer required)
First Name:
Last Name:
Credentials:
NPI number:
Facility Address:
Email address:
Facility affiliation:
NCDR Participant ID:
Please answer question 1 (First Name:) before continuing.
Please answer question 1 (Last Name:) before continuing.
Please answer question 1 (Credentials:) before continuing.
Please answer question 1 (NPI number:) before continuing.
Please answer question 1 (Facility Address:) before continuing.
Please answer question 1 (Email address:) before continuing.
Your answer to question 1 (Email address:) must be a valid email address.
Please answer question 1 (Facility affiliation:) before continuing.
Please answer question 1 (NCDR Participant ID:) before continuing.
2.
Which of the following MIPS approved ACC Quality Campaigns (ACC Patient Navigator Program: Focus MI Campaign and/or the ACC Reduce the Risk: PCI Bleed Campaign) has your facility opted into for 90 days or more? (Please select all that apply.)
(answer required)
Reduce the Risk: PCI Bleed Campaign
Have not participated in either of these campaigns for 90 days or more
Please answer question 2 before continuing.
Please select at least 1 choices for question 2.
3.
Has your facility engaged continuously in a MIPS approved ACC Quality Campaign (e.g., ACC Reduce the Risk: PCI Bleed Campaign) for at least 90 days in 2018?
(answer required)
Yes
No
Please answer question 3 before continuing.
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