Financial Navigation Program

Activity ID

Activity Weighting

Subcategory Name

Beneficiary Engagement

Activity Description

In order to receive credit for this activity, MIPS eligible clinicians must attest that their practice provides financial counseling to patients or their caregiver about costs of care and an exploration of different payment options. The MIPS eligible clinician may accomplish this by working with other members of their practice (for example, financial counselor or patient navigator) as part of a team-based care approach in which members of the patient care team collaborate to support patient- centered goals. For example, a financial counselor could provide patients with resources with further information or support options, or facilitate a conversation with a patient or caregiver that could address concerns. This activity may occur during diagnosis stage, before treatment, during treatment, and/or during survivorship planning, as appropriate.

Validation

Demonstration by eligible clinicians and groups that their practice provides an estimate of the cost to the patient of the types of health care services it will furnish in advance (for services that can be scheduled in advance) and financial counseling to patients or their caregiver about cost of care with evidence that an exploration of different payment options were discussed. Financial counseling may occur during diagnosis stage, before treatment, during treatment, and/or during survivorship planning, as appropriate.

Suggested Documentation

Demonstration by eligible clinicians and groups that their practice provides an estimate in advance of the cost to the patient of the types of health care services it will furnish (for services that can be scheduled in advance) and financial counseling to patients or their caregiver about costs of care with evidence that an exploration of different payment options, e.g. documented work with a financial counselor or patient navigator as part of a team-based care approach in which members of the patient care team collaborate to support patient- centered goals were discussed.

Please note: a financial counselor could provide patients with resources with further information or support options, or facilitate a conversation with a patient or caregiver that could address concerns.