Checklist for Eligible Professionals- AIU
STEP 1: Register with the Centers for Medicare and Medicaid Services (CMS)
Register with CMS at https://ehrincentives.cms.gov/hitech/loginCredentials.action
To register, eligible professionals will need the following information:
 National Plan and Provider Enumeration System (NPPES) User ID & Password
 Eligible Provider’s NPI
 Payee NPI & Tax Identification Number (TIN)
 EHR Certification Number (http://oncchpl.force.com/ehrcert?q=chpl)
Need help getting this information?
NPPES (800) 465-3203 or https://nppes.cms.hhs.gov/IAWeb/login.do?fwdurl=/ and select “forgot
password” or “forgot user ID”
IMPORTANT: Upon successful registration, applicants will receive a CMS Registration ID.
STEP 2: Enroll in VA Medicaid EHR Incentive Program
Within a few days of successfully completing Step 1, the eligible professional will receive an email from
the Virginia Medicaid Incentive Program (VMIP) system inviting them to enroll in the VMIP at
https://www.virginiamedicaidehr.dmas.virginia.gov/VIRGINIA/enroll/logon.
The eligible professional will need the following information to log in (the information used to populate
this section should match the information used for registration with CMS):
 Individual NPI
 Social Security Number
 CMS Registration ID
 Establish a VMIP password
STEP 3: Attestation
The following questions will be asked to help eligible professionals determine their program eligibility:
Are you a hospital based provider?
 Definition: an eligible professional who furnishes 90% or more of their covered professional
services in sites of service identified by the codes used in the HIPAA standard transaction as an
inpatient hospital or ER setting in the year preceding the payment year is considered hospital
based.
EP AIU Checklist – 2014 Version
Page 1
Checklist for Eligible Professionals- AIU

The hospital-based exclusion does not apply to an eligible professional practicing predominantly
through a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC).
Are you attesting as a Pediatrician?
 For purposes of VMIP only, a pediatrician means a medical doctor, who diagnoses, treats,
examines, and prevents diseases and injuries in children. A pediatrician must hold a Doctor of
Medicine (MD) or Doctor of Osteopathy (DO) degree and hold a current, in good-standing board
certification in pediatrics through the American Board of Pediatrics, the American Board of
Surgery, the American Board of Radiology, the American Board of Urology, or the American
Osteopathic Board of Pediatrics, or a current, in good standing, pediatric subspecialty certificate
recognized by the American Board of Medical Specialties.
Do you practice predominantly in an FQHC/RHC?
 FHQC/RHC = Federally Qualified Health Center / Rural Health Clinic
 An eligible professional “practices predominantly” when the clinical location for over 50% of his
or her total patient encounters over a period of 6 months within the most recent calendar year
or, within the 12-month period preceding attestation, occurs at an FQHC or RHC.
Eligible professionals will be asked to verify their payee information designated during CMS registration
by selecting the Payee NPI.
Select your Patient Volume Reporting Period, which should be a continuous 90-day period beginning on
the first day of a month either from the preceding calendar year or in the most recent 12-month period.
Were out-of-state encounters included in the eligible professional’s patient volume calculation?
 If yes, enter the states or territories
During the 90-day reporting period, enter the Eligible Professional’s:
 Medicaid encounters
 Total encounters
Eligible professionals will be asked to upload documentation supporting their patient volume
calculation.
 Reports to support Medicaid volume from your practice management system. These reports
should include:
o Dates of service for the Medicaid encounters included in your volume
o Medicaid Client ID
o Claim Status (Paid/Denied)
o Provider’s NPI & Tax ID
o Source of the data (name of practice management or other system used to compile the
information)
EP AIU Checklist – 2014 Version
Page 2
Checklist for Eligible Professionals- AIU
 Screen shot of the practice management’s landing, login, or homepage and/or copy of the
filter/query page used to obtain the Medicaid encounter identifiers. If the query/filter page
contains the name or logo of the software, it will be accepted alone, if it does not, both
documents must be supplied.
*Encounters administered through the State Children’s Health Insurance Program standalone program (S-CHIP)
do not count toward the Medicaid encounters volume criteria. For more information on the S-CHIP standalone
program, see the Resources section at the end of this document.
Is the eligible professional adopting, implementing or upgrading to certified EHR technology? (Select
one)
What is the CMS EHR Certification Number?
 Upload screen shot pasted onto a Word document or converted to .pdf format. This can be
obtained by searching http://oncchpl.force.com/ehrcert?q=chpl
Eligible professionals will be required to upload AIU supporting documentation.
 Supporting documentation must demonstrate a relationship to the eligible professional
submitting the evidence of AIU and must demonstrate that the eligible professional has a
financial and/or legally binding agreement with the EHR vendor. Please see examples of
supporting documents below (all are not required):





Purchase Order
Contract
Receipts
EHR Software License
Training provided (evidence of cost or
contract)




Hiring (job description or payroll
records)
Maintenance agreements
Upgrade documentation
Data exchange agreement
 If the provider is not specifically named on the AIU documentation, an additional letter explaining the
relationship between the provider and the EHR vendor must also be uploaded.
To complete attestation, the eligible professional must sign the legal notice (enter name and re-enter their CMS
Registration ID), verify their information, and "Confirm and Submit" their application.
The eligible professional should review the "Enrollment Summary" and then scroll down to select "Confirm & Submit" to
send the application for processing.
Congratulations! Attestation in the VMIP system is complete. Remember to print a copy of the confirmation page for
your records.
EP AIU Checklist – 2014 Version
Page 3
Checklist for Eligible Professionals- AIU
Once the VMIP application is successfully submitted, the eligible professional's enrollment status will change to
"Payment Pending." The eligible professional cannot modify any data entered when the enrollment status is "Payment
Pending."
STEP 4: Check Your Email
VMIP will be sending the provider e-mails throughout the enrollment process indicating their current status in the
program (e.g., registration received from CMS, confirming enrollment in VMIP and payment pending, etc.). These
notifications are sent from an unmonitored mailbox from VMIP with the address: “VADONOTREPLY@VirginiaPIP.com.”
Please do not respond to this mail box.
IMPORTANT: Add “VADONOTREPLY@VirginiaPIP.com” to your address book and/or add it to your “trusted sender”
list in your spam filter or software that places messages from unrecognized senders in your junk mail folder. This will
ensure that you get these messages from VMIP.
Page 4
Checklist for Eligible Professionals- AIU
Requesting S-CHIP Encounters Information
You may request a list of S-CHIP standalone encounters which must be EXCLUDED from the volume calculation for a cost
of $7.00 plus $0.10 per printed page.
Send requests for this report to:
 foia@dmas.virginia.gov
 Include from and to dates of service
 Specifically ask for the CHIP Stand-Alone Report for the EHR Incentive program
 Include the provider’s name, NPI and Tax ID#
Upon receipt, EXCLUDE these totals from your patient volume calculation. Maintain all reports for audit purposes.
What if I am unable to generate a Medicaid encounters report from my system?


Providers can request a Medicaid encounters if they are unable to generate one from their own internal
systems. The cost for this report is $100.00.
Send requests to:
o foia@dmas.virginia.gov
o Request the “Encounter Report excluding standalone CHIP to include only client ID (line item detail is
not needed) Date of Service, Amount Paid and Denial Reason in an Excel Format. Please restrict data to
only fields requested and advise of charges prior to sending data.”
o Specify Provider Name, NPI, TID, Dates of Service being requested
Resources
What is S-CHIP? http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Childrens-Health-InsuranceProgram-CHIP/Downloads/CHIP_report_Congress.pdf
For more information on Virginia Medicaid and FAMIS http://www.dmas.virginia.gov/Content_atchs/mc/mcguide_p1.pdf
EHR Certification Number Search http://oncchpl.force.com/ehrcert?q=chpl
Medicaid EHR Incentive Program Guide http://www.cms.gov/Regulations-andGuidance/Legislation/EHRIncentivePrograms/Downloads/EHR_Medicaid_Guide_Remediated_2012.pdf
Virginia Medicaid EHR Incentive Program Website https://www.virginiamedicaidehr.dmas.virginia.gov
Virginia Medicaid EHR Incentive Program help desk 1-877-589-9113 or VASupport@virginiapip.com
Other lost or forgotten passwords
 NPPES (NPI) 1-800-465-3203
 CMS Incentive Registration 1-888-734-6433 or https://ehrincentives.cms.gov/hitech/login.action
Page 5