Why isn’t this in the payer’s report? Has the claim not been processed yet? This seems like extra work for the provider, assuming the claim will hit the payer system and change the quality report. A better example would be that the patient had the colonoscopy a few months ago when she was a member of a different insurer – so the new payer isn’t aware, which would justify the physician taking the time to submit a report to the payer.

Existing Wording:

 Client, such as a provider, will use the care-gaps operation to request a Colorectal Cancer Screening measure gaps in care report for his/her patients from the Server, such as a payer.