Providers who opt to send their medical documentation electronically to Centers for Medicare and Medicaid Services contractors will need to do some shopping. You'll have choices regarding who will be the designated "health information handler" (HIH)--which can include electronic health record vendors and health information exchanges--to send your data to CMS, as well as how you'll submit records to that HIH, and even how to pay for the service.
Those are just a few of the details made public by CMS about its electronic submission of medical documentation (esMD) pilot program, set to launch in September, according to Melanie Combs-Dyer, Deputy Director of CMS's Office of Financial Management, Provider Compliance Group, who participated in a webcast last week. She expects that 2,000 Part A providers and 25,000 Part B providers will have signed up by December, with participation ramping up after that.
Currently, providers that receive requests for medical documentation from CMS contractors must submit the documents via regular mail or fax, even if the provider uses an EMR. The esMD program will enable providers to use the HIH's gateways to transfer health information electronically, using the standardized processes of the Nationwide Health Information Network. The HIH sends the records to a CMS repository, where the contractor then pulls the records for review.
Seven companies already have been selected as HIHs, and more are slated to participate.
Providers that don't use an EMR still can use esMD by converting their records into PDF files. CMS hopes to expand the esMD program to allow for electronic submission of refund requests, enrollment forms, appeals and other communications.
Phase II of the esMD program, in which providers can choose to receive requests for documentation electronically from CMS contractors through HIHs, is scheduled to go live in late 2012, according to Combs-Dyer.
To learn more:
- check out Combs-Dyer's presentation (.pdf)
- here's CMS's overview of the esMD program