CMS to pilot e-submission of medical documentation
The Centers for Medicare & Medicaid Services (CMS) is testing a mechanism that will enable providers in the Medicare fee-for-service (FFS) program to submit documentation electronically, lowering chances of improper payment and reducing paperwork for providers.
Each year, the FFS program makes billions of dollars in estimated improper payments, CMS stated. CMS employs review contractors, including Medicare Recovery Audit Contractors, the Comprehensive Error Rate Testing Contractor and Medicare Administrative Contractors, to measure, prevent, identify and correct improper payments. Each year, these organizations request and receive more than 1 million medical records from providers.
Providers currently have only two options—mailed paper or faxes—for submitting records, according to CMS. In phase 1 of the Electronic Submission of Medical Documentation (esMD) pilot, slated to go live in August, review contractors will continue to send medical documentation requests via paper mail. However, providers will have the option of sending the requested documentation electronically.
During phase 2, review contractors will electronically send documentation requests to providers when their claims are selected for review. CMS plans to go live with esMD Phase 2 in 2012.
esMD utilizes Nationwide Health Information Network CONNECT-compatible gateways to keep documents secure as they move from the provider to the requesting contractor, according to QSSI, of Columbia, Md. CMS hired QSSI to be its esMD gateway contractor.
Click here to read more about the esMD program, including a list of Review Contractors participating in the pilot.
Each year, the FFS program makes billions of dollars in estimated improper payments, CMS stated. CMS employs review contractors, including Medicare Recovery Audit Contractors, the Comprehensive Error Rate Testing Contractor and Medicare Administrative Contractors, to measure, prevent, identify and correct improper payments. Each year, these organizations request and receive more than 1 million medical records from providers.
Providers currently have only two options—mailed paper or faxes—for submitting records, according to CMS. In phase 1 of the Electronic Submission of Medical Documentation (esMD) pilot, slated to go live in August, review contractors will continue to send medical documentation requests via paper mail. However, providers will have the option of sending the requested documentation electronically.
During phase 2, review contractors will electronically send documentation requests to providers when their claims are selected for review. CMS plans to go live with esMD Phase 2 in 2012.
esMD utilizes Nationwide Health Information Network CONNECT-compatible gateways to keep documents secure as they move from the provider to the requesting contractor, according to QSSI, of Columbia, Md. CMS hired QSSI to be its esMD gateway contractor.
Click here to read more about the esMD program, including a list of Review Contractors participating in the pilot.