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Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleI.IntroductionThis guide is for users who do not have an Enterprise Identity Data Management (EIDM) or an Individuals AuthorizedAccess to the CMS Computer Services (IACS) account. This guide provides step-by-step instructions on how users cansign up for an EIDM account for the first time and how to request a role to access the ‘Physician Quality and ValuePrograms’ application using the EIDM in the CMS Enterprise Portal.Note: Do not use this guide (1) if you already have an EIDM account or (2) if you already have an active IACSaccount with a Physician Value – Physician Quality Reporting System (PV-PQRS) role. Pleasevisit R.html to determine which guide you should use based on your needs.A.Before requesting a ‘Physician Quality and Value Programs’ role for your EIDM account, you will first need todetermine which one of the following four user roles you want to request: Security Official role: The Security Official role allows the user to perform the following tasks on behalf of a grouppractice:o Register the group practice to participate in the Physician Quality Reporting System (PQRS) Group PracticeReporting Option (GPRO);o Obtain the group practice’s Mid-Year and Annual Quality and Resource User Report (QRUR), SupplementalQRUR, and PQRS Feedback Report;o Submit an informal review request on behalf of the group practice; ando Approve requests for the ‘Group Representative’ role in the EIDM. Group Representative role: The Group Representative role allows the user to perform the following tasks on behalfof a group practice:o Register the group practice to participate in the PQRS GPRO;o Obtain the group practice’s Mid-Year and Annual QRUR, Supplemental QRUR, and PQRS Feedback Report; ando Submit an informal review request on behalf of the group practice.Note: Group practices are identified in the EIDM by their Medicare billing Taxpayer Identification Number(TIN). A group practice consists of two or more eligible professionals (as identified by their National ProviderIdentifier [NPI]) that bill under the TIN. To find out if a group practice is already registered in the EIDM and whois the group practice’s Security Official, please contact the QualityNet Help Desk and provide the group practice’sTIN and the name of the group practice. Individual Practitioner role: The Individual Practitioner role allows the user to perform the following tasks onbehalf of a solo practitioner:o Obtain the solo practitioner’s Mid-Year and Annual QRUR, Supplemental QRUR, and PQRS Feedback Report;ando Approve requests for the ‘Individual Practitioner Representative’ role in the EIDM. Individual Practitioner Representative role: The Individual Representative role allows the user to perform thefollowing task on behalf of the solo practitioner:o Obtain a solo practitioner’s Mid-Year and Annual QRUR, Supplemental QRUR and PQRS Feedback Report.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST1

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleNote: Solo Practitioners are identified in the EIDM by their Medicare billing TIN and rendering NPI. A solopractitioner consists of only one eligible professional (as identified by the NPI) that bills under the TIN. To findout if a solo practitioner is already registered in the EIDM and who is the solo practitioner’s IndividualPractitioner, please contact the QualityNet Help Desk and provide the solo practitioner’s TIN and the name of thesolo practitioner.Information about registering to participate in the PQRS GPRO and obtaining QRURs is availableat se gather the following information before you begin the process for signing up for an EIDM account for thefollowing user role: Security Official:o Your Information: First Name, Last Name, E-mail Address, Social Security Number, Date of Birth, HomeAddress, City, State, Zip Code, and Primary Phone Number.o Business Contact Information: Company Name, Address, City, State, Zip Code, Company Phone Number, andOffice Phone Number.o Organization Information: Group practice’s Medicare billing TIN, Legal Business Name, Rendering NPIs fortwo different eligible professionals who bill under the TIN and their corresponding individual ProviderTransaction Access Numbers (PTANs) (do not use the GROUP NPI or GROUP PTAN), Address, City, State, ZipCode, and Phone Number. Group Representative:o Your Information: First Name, Last Name, E-mail Address, Social Security Number, Date of Birth, HomeAddress, City, State, Zip Code, and Primary Phone Number.o Business Contact Information: Company Name, Address, City, State, Zip Code, Company Phone Number, andOffice Phone Number.o Organization Information: Group practice’s Medicare billing TIN; or the Legal Business Name and the State;or the Legal Business Name and the Street Address. Individual Practitioner:o Your Information: First Name, Last Name, E-mail Address, Social Security Number, Date of Birth, HomeAddress, City, State, Zip Code, and Primary Phone Number.o Business Contact Information: Company Name, Address, City, State, Zip Code, Company Phone Number, andOffice Phone Number.o Professional Information: Solo practitioner’s First Name, Solo practitioner’s Last Name, Legal Business Name,Solo practitioner’s Medicare billing TIN, Solo practitioner’s rendering NPI and the corresponding individualPTAN (do not use the GROUP NPI or GROUP PTAN), Address, City, State, Zip Code and Phone Number. Individual Practitioner Representative:o Your Information: First Name, Last Name, E-mail Address, Social Security Number, Date of Birth, HomeAddress, City, State, Zip Code, and Primary Phone Number.o Business Contact Information: Company Name, Address, City, State, Zip Code, Company Phone Number, andOffice Phone Number.o Professional Information: Solo practitioner’s Medicare billing TIN; or the Legal Business Name and the State;or the Legal Business Name and the Street Address.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST2

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleC.II.Step-by-Step Instructions: You have twenty-five (25) minutes to complete each screen (unless a different timeis noted on the screen). Otherwise, you will lose all of the information you entered and will need to start theprocess again.QuestionsFor questions related to setting up an EIDM account, please contact the QualityNet Help Desk at: Monday – Friday: 8:00 am – 8:00 pm EST Phone: (866) 288-8912 (TTY 1-877-715-6222) Email: qnetsupport@hcqis.orgFor additional information on how to sign up for a new EIDM account and how to request a role to access the ‘PhysicianQuality and Value Programs’ application using the EIDM, please visit R.html.III.I.II.III.IV.V.Table of ContentSection NameIntroductionQuestionsTable of ContentNew User Registration for an EIDM Accounta) Requesting a Security Official Roleb) Requesting a Group Representative Rolec) Requesting an Individual Practitioner Roled) Requesting an Individual Practitioner Representative RoleCompleting the Multi-Factor Authentication (MFA)Page Number13341824263234If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST3

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleIV.New User Registration for an EIDM Account – Please follow each step listed below unlessotherwise noted.Steps1. Go to https://portal.cms.gov/ andselect New User Registration.ScreenshotsNote: The CMS Enterprise Portalsupports the following internet browsers: Internet Explorer 8 (withoutcompatibility mode) Internet Explorer 9 (withoutcompatibility mode) Internet Explorer 10 (withoutcompatibility mode) Mozilla-Firefox Chrome SafariEnable JavaScript and adjust any zoomfeatures to ensure you are not seeing thescreen in too wide of a view.2. Read the Terms and Conditions.Select the I agree to the terms andconditions checkbox and select Next.Note: Next will be enabled only afterchecking the I agree to the terms andconditions checkbox.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST4

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps3. Enter the following requiredinformation under Your Informationsection and select Next. First Name Last Name E-mail Address Confirm E-mail Address Social Security Number Date of Birth Home Address Line 1 City State Zip Code Primary Phone NumberScreenshotsIf you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST5

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps4. (a) Create your EIDM User ID andEIDM Password.ScreenshotsNote: Your EIDM User ID must be aminimum of six (6) and a maximum ofseventy four (74) alphanumericcharacters. It must contain at least 1letter and cannot contain your SocialSecurity Number or any 9 consecutivenumbers. Allowed special characters aredashes (-), underscores ( ), apostrophes('), @ and periods (.) followed byalphanumeric characters.Note: Your EIDM Password must be aminimum of eight (8) and a maximum oftwenty (20) characters in length. It mustcontain at least one (1) letter, one (1)number, one (1) uppercase letter, and one(1) lowercase letter. It cannot containyour User ID and the following specialcharacters may not be used: ?, , , (, ),', ", /, , and &. Your password must bechanged at least every 60 days and canonly be changed once a day.(b) Select and provide the answer tothree (3) challenge questions underSelect your Challenge Questionsand Answers section.(c) Select Next.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST6

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps5. Your registration for an EIDMaccount is now complete. You willreceive an E-mail acknowledgingyour successful account creation withyour EIDM User ID.ScreenshotsSelect OK to navigate to the CMSEnterprise Portal in order to request auser role for the ‘Physician Qualityand Value Programs’ application.Note: Wait approximately five (5) minutesbefore logging in to the portal with yourEIDM User ID and EIDM Password.6. Select Login to CMS Secure Portalon the CMS Enterprise Portal.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST7

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps7. Read Terms and Conditions andselect I Accept to continue.Screenshots8. Enter the following information andselect Log In: EIDM User ID EIDM PasswordIf you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST8

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps9. Select Request Access Now underRequest Access to begin the processof requesting a new user role.ScreenshotsNote: You may also select your usernameand then select My Access from the dropdown menu to begin the process ofrequesting a new user role.10. Select Request Access for thePhysician Quality and ValuePrograms application within theAccess Catalog.Note: The Access Catalog list presentedis in alphabetical order. Scroll down untilyou find the Physician Quality and ValuePrograms application or enter the firstfew letters of the application in the AccessCatalog text box to narrow down theselection criteria.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST9

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps11. (a) Under Select a Group, chooseProvider Approver, if you arerequesting Security Official orIndividual Practitioner roleOR(b) Choose PV Provider, if you arerequesting Group Representative orIndividual PractitionerRepresentative role.ScreenshotsNote: The Select a Role option will bevisible after making a selection for theSelect a Group option. The Next buttonwill be visible after making a selection forSelect a Role option.12. Select the appropriate role you wantto request from the Select a Roledrop-down menu.Select Next to begin Remote IdentityProofing (RIDP) and Multi-FactorAuthentication (MFA) processes.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST10

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsScreenshotsRemote Identity Proofing (RIDP) - Please follow steps 13 to 17 to begin the RIDP process.This process is used to verify your identity and is done by asking random questions based on yourpersonal and financial history. Additional information on how the RIDP process works can be found RUR.html.13. Select Next to complete the IdentityVerification section.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST11

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps14. Read the Terms and Conditions.Select the I agree to the terms andconditions checkbox and then selectNext.ScreenshotsNote: Next will be enabled only afterchecking the I agree to the terms andconditions checkbox.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST12

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps15. Confirm your E-mail Address andenter your Social Security Number.Select Next after verifying the prepopulated information.ScreenshotsIf you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST13

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps16. Provide an answer to each questionunder the Verify Identity section.ScreenshotsSelect Next to continue.Note: Verify Identity questions areprovided from Experian based on theinformation provided in step 15.17. Remote Identity Proofing is nowcomplete. Select Next to proceed toregister for the Multi-FactorAuthentication process.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST14

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsScreenshotsMulti-Factor Authentication (MFA)Please follow steps 18 to 21 to register for MFA. MFA is an approach to security authentication which requires usersto provide more than one form of verification in order to prove their identity. MFA registration is required onlyonce when you are requesting a user role, but will be verified every time you log into the CMS Enterprise Portal.Additional information on how the MFA process works can be found at R.html.18. Select Next to begin registration forthe Multi-Factor Authenticationprocess.19. Read the Register Your Phone,Computer, or E-mail notificationand then select an option from theCredential Type drop-down menu.Note: Regardless of the mechanism youchoose, you will have 30 minutes toretrieve and enter the Security Code. Ifyou are unable to enter the code within 30minutes, then the code will expire and youneed to request a new Security Code.If selecting Phone/Tablet/PC/Laptop asCredential Type, you will first need toensure you have the VIP Client andappropriate VIP Access softwaredownloaded to your device. The VIPClient and VIP Access software can bedownloaded via the Symantec Site (directlink is provided on your screen). Refer tothe hyper link on the right screen to makeselection. If the VIP Client and VIPAccess software is not installed on yourdevice, you will be unable to complete theMulti-Factor Authentication process.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST15

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsScreenshots20. (a) If selectingPhone/Tablet/PC/Laptop asCredential Type, enter thealphanumeric code that displaysunder the field label Credential ID asCredential ID and Device ID as theCredential Description.OR(b) If selecting E-mail – One TimePassword (OTP) as Credential Type,the email associated with the EIDMaccount will be entered as E-mailAddress to obtain the security code.Enter E-mail as the CredentialDescription.OR(C) If selecting Text Message – ShortMessage service (SMS) asCredential Type, enter the PhoneNumber that will be used to obtainthe security code as Phone Numberand Text as the CredentialDescription.OR(D) If selecting Voice Message –Interactive Voice Response (IVR) asCredential Type, enter the PhoneNumber that will be used to obtainthe security code as Phone Numberand IVR as Credential Description.Select Next to continue.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST16

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps21. Your registration for the MultiFactor Authentication is nowcomplete. Select Next to proceed torequest a user role in order to accessthe 'Physician Quality and ValuePrograms' application.ScreenshotsNote: You will receive an E-mailnotification for successfully registeringthe MFA credential type.22. Enter the required information underBusiness Contact Information andPhone sections and select Next.Note: The information under the Namesection will be pre-populated with theRemote Identity Proofing informationfrom step 15. If you are requesting a SecurityOfficial role, go to step 23.If you are requesting a GroupRepresentative role, go to step 30.If you are requesting anIndividual Practitioner role, go tostep 33.If you are requesting anIndividual PractitionerRepresentative role, go to step 40.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST17

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsScreenshotsFollow Steps 23 to 29 to Request a ‘Security Official’ Role23. a) If you are the first person in yourgroup practice to sign up for theSecurity Official role and registeryour group practice in the EIDM,select Create an Organization. Then,proceed to Step 24.OR(b) If you are signing up for aSecurity Official role and your grouppractice already exists in the EIDM,select Associate to an ExistingOrganization. Then, proceed to Step27.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST18

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps24. If selecting Create an Organizationas the Create/Associate option, enterthe following required information forthe group practice: ScreenshotsMedicare Billing TINLegal Business NameNPI 1PTAN 1NPI 2PTAN 2AddressCityStateZip CodePhone NumberReason for RequestSelect Next.Note: In this section, enter your grouppractice’s Medicare billing TIN; enterrendering NPIs for two different eligibleprofessionals who bill under the TIN (donot use the group NPI) and enter theircorresponding individual PTANs (do notuse the group PTAN); and enter theremaining required information.Example: Healthy Clinic with Medicarebilling TIN 74-7575757 has ten eligibleprofessionals in the group. Enter therendering NPI and individual PTANcombinations for two of the eligibleprofessionals: Dr. Smith and Dr. Beaver. Dr. Smith’s rendering NPI is4545454545 and the correspondingindividual PTAN is G676767676.Note: PTANs are alphanumeric therefore,enter the alpha characters. Dr. Beaver’s rendering NPI is2525252525 and the correspondingindividual PTAN is 0012789456.Note: All leading zeros in the PTANIf you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST19

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsshould be entered.25. Verify the information on theVerification screen and selectSubmit.ScreenshotsIf you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST20

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps26. (a) You have successfully applied forthe Security Official role.Screenshots(b) If your role request isautomatically approved, proceed toStep 43 to complete the Multi-FactorAuthentication before you can accessthe 'Physician Quality and ValuePrograms' application using yourEIDM User ID and EIDM passwordin order to: Register the group practice toparticipate in the PQRS GPRO; Obtain the group practice’s MidYear and Annual QRUR,Supplemental QRUR, and PQRSFeedback Report; and Submit an informal reviewrequest on behalf of the grouppractice.A confirmation E-mail will be sent shortlyafter the submission confirmationmessage.Note: You have three (3) attempts to entertwo valid NPI/PTAN combinations fortwo different eligible professionals whobill under the TIN. If the information is aconfirmed match, the request will beautomatically approved. If you exceedthese attempts, your request will be sentto the QualityNet Help Desk for manualapproval. The QualityNet Help Desk willcontact you for further assistance withintwo (2) business days.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST21

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps27. (a) If selecting Associate to anExisting Organization as theCreate/Associate option, enter one ofthe following information for thegroup practice:i.ii.iii.ScreenshotsMedicare Billing TINORLegal Business Name and StateORLegal Business Name and StreetAddress(b) Select Search.(c) Select your group practice fromthe Organization drop-down menu.Enter Reason for Request and selectNext.Note: If your group practice cannot befound, please verify that your grouppractice already has a user with anapproved Security Official role and youentered the group practice’s Medicarebilling TIN correctly. If you do not knowthe Security Official, contact theQualityNet Help Desk.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST22

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps28. Verify the information on theVerification screen and selectSubmit.Screenshots29. (a) You have successfully applied forthe Security Official role.Note: Another Security Official fromyour group practice must approveyour request within sixty (60) daysafter it is submitted; otherwise, therequest will be canceled and need tobe resubmitted.(b) After your role request isapproved, proceed to Step 43 tocomplete the Multi-FactorAuthentication before you can accessthe ‘Physician Quality and ValuePrograms’ application using yourEIDM User ID and EIDM passwordin order to: Register the group practice toparticipate in the PQRS GPRO; Obtain the group practice’s MidYear and Annual QRUR,Supplemental QRUR, and PQRSFeedback Report; and Submit an informal reviewrequest on behalf of the grouppractice.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST23

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsScreenshotsFollow Steps 30 to 32 to Request a ‘Group Representative’ Role30. (a) Enter one of the followinginformation for the group practice.i.ii.iii.Medicare Billing TINORLegal Business Name and StateORLegal Business Name and StreetAddress(b) Select Search.(c) Select your group practice fromthe Organization drop-down menu.Enter Reason for Request and selectNext.Note: If your group practice cannot befound, please verify that your grouppractice already has a user with anapproved Security Official role and youentered the group practice’s Medicarebilling TIN correctly. If you do not knowyour Security Official, contact theQualityNet Help Desk.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST24

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps31. Verify the information on theVerification screen and selectSubmit.Screenshots32. (a) You have successfully applied forthe Group Representative role.Note: A Security Official from your grouppractice must approve your request withinsixty (60) days after it is submitted;otherwise, the request will be canceledand need to be resubmitted.(b) After your role request isapproved, proceed to Step 43 tocomplete the Multi-FactorAuthentication before you can accessthe ‘Physician Quality and ValuePrograms’ application using yourEIDM User ID and EIDM passwordin order to: Register the group practice toparticipate in the PQRS GPRO; Obtain the group practice’s MidYear and Annual QRUR,Supplemental QRUR, and PQRSFeedback Report; and Submit an informal reviewrequest on behalf of the grouppractice.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST25

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleStepsScreenshotsFollow Steps 33 to 39 to Request an ‘Individual Practitioner’ Role33. (a) If you are the first person (the solopractitioner or an authorizedrepresentative of the solo Practitioner)to sign up for an IndividualPractitioner role on behalf of a solopractitioner and register the solopractitioner in the EIDM, selectCreate a New Individual EligibleProfessional. Then, proceed to Step34.OR(b) If you are signing up for anIndividual Practitioner role and thesolo practitioner already exists in theEIDM, select Associate to anExisting Individual EligibleProfessional. Then proceed to Step37.If you have questions about the or need assistance accessing any of the reports, please contact the QualityNet Help Desk by phone at 866288-8912. Normal business hours are Monday-Friday from 8 am to 8 pm EST26

Guide for Obtaining a New EIDM Account with a ‘Physician Quality and ValuePrograms’ RoleSteps34. If selecting Create a new IndividualEligible Professional as theCreate/Associate Individual option,enter the following requiredinformation for the solo practitioner: Individual Eligible Professional’s(Solo Practitioner’s) First Name Individual Eligible Professional’s(Solo Practitioner’s) Last Name Legal Business Name Medicare Billing TIN Rendering NPI Individual PTAN Address City State Zip Code Phone Number Reason for RequestScreenshotsSelect Next.Note: In this section, enter the solopractitioner's Medicare billing TIN,rendering NPI, and the correspondingindividual PTAN (do not us

only one eligible professional (as identified by the NPI) that bills under the TIN. To find out if a solo practitioner is already registered in the EIDM and who is the solo practitioner’s Individual Practitioner, please contact the QualityNet Help Desk and provide the solo practitioner’s TIN and the name of the solo

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