QPP Eligibility API - Pulling Eligibility for Practice

[Dafydd C]

Hi,

Our QCDR is exploring integrating the QPP eligibility API so that we can display eligibility information to providers looking to submit to MIPS through the QCDR. It appears we are unable to pull TIN information from the API for a supplied NPI nor are we able to pull eligibility status information based on TIN alone.  When we attempt a call via https://qpp.cms.gov/api/eligibility/secure/npis/ the TIN is hidden ("XXXXXXXXX").  Per the documentation, it seems we would need to be authorized by the organization to see this information?  Is there no way for us to tie eligibility information for the practice to a TIN via the eligibility API?  And is it true we would need authorization from every organization?

Thank you,

Dafydd

[Craig Powell]

Dafydd,

Correct.  Registry tokens are not allowed to use the /api/eligibility/secure/npis endpoint because that type of token cannot be tied to a specific TIN or group of TINs by the Authentication service. In order to use that API endpoint, you would have to go through the Auth process to get a user token that grants them either explicit or implicit authorization for the TIN or TINs that they need.

Please let us know if you have additional questions

Craig

QPP Team

[Dafydd C]

Hi Craig,

Thank you.  Seeing as how our QCDR supports 100's of TINs we would need to obtain authorization for each?  Is there another endpoint or API that would allow to pass a TIN to see that TINs eligibility status?  Our end goal is to use the resulting eligibility information to limit the available submission options to a practice or provider when they submit for MIPs.

Thank you,

Dafydd

On Wednesday, January 15, 2020 at 11:58:19 AM UTC-5, Craig Powell wrote:

Dafydd,

Correct.  Registry tokens are not allowed to use the /api/eligibility/secure/npis endpoint because that type of token cannot be tied to a specific TIN or group of TINs by the Authentication service. In order to use that API endpoint, the person in the Google Groups post will have to go through the Auth process to get a user token that grants them either explicit or implicit authorization for the TIN or TINs that they need.

[David C]

Checking in again on this question.  Thank you.

[Shane Jarrell]

bump

[Craig Powell]

Dafydd

Try the secure Opt In endpoint

https://qpp.cms.gov/api/eligibility/docs/secure/#/Authenticated/get_api_eligibility_secure_opt_in

Let us know if that works

Craig 

QPP Team

[Shane Jarrell]

Thanks for the response. I am calling the secure endpoint. https://preview.qpp.cms.gov/api/eligibility/secure/opt-in?year=2019

[Sachin Vijay Pawar]

Hello Craig,

We were using this URL - https://preview.qpp.cms.gov/api/eligibility/secure/opt-in?year=2019  for testing the opt-in scenarios but we are unable to get the output using the test NPI / TINs.

Can we use this secure URL for testing purposes?

Need confirmation on this in order to avoid the actual opt-in to happen for any provider by mistake.

 

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Thanks and Regards,

Sachin Vijay Pawar

Senior Test Engineer

Business Group: Product Engineering

Unit: Testing

 

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Please do not include any Protected Health Information (PHI) when responding to this email!  

FIGmd does not transmit via email any healthcare information protected by federal and/or state laws unless authorized by the subject patient or under circumstances where patient authorization is not required. If FIGmd receives PHI directly from a subject patient, we consider this to be an authorized distribution of PHI by the subject patient. 

 

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[Craig Powell]

Shane and Sachin,

The original post on this thread from Dafydd pertained to getting production information for TINs, NPIs and TIN/NPI combinations, specifically around why, in some cases, TIN's are hidden (XXXXXXX) when using a QCDR or registry token.  Dafydd was using production endpoints... 

https://qpp.cms.gov/api/eligibility ... which access production data.

That's quite different than questions surrounding test scenarios using the Developer Preview (DevPre) test environment and endpoints that access it

https://preview.qpp.cms.gov/api/eligibility

There are several threads running about test scenarios, particularly pertaining to Opt In status.  For information about that topic, please follow

https://groups.google.com/forum/?utm_medium=email&utm_source=footer#!topic/qpp-apis/lvx2iikRivo

... which both of you appear to be following.  If you feel none of the existing threads address your situation, please start a new thread with your specific issue.

Regards

Craig

QPP Team