Electronic Submission of Medical Documentation (esMD)

CMS now offers providers a new mechanism for submitting medical documentation when it is requested by a review contractor. CMS’s new system is called the Electronic Submission of Medical Documentation (esMD).

How to submit Medical Records Electronically?
If a provider wants to electronically submit medical documentation to a CMS review contractor, they must either build a gateway, or obtain gateway services from a Health Information Handler (HIH) of their choice.

If a provider chooses to build a gateway to send records to CMS, the gateway must use the Nationwide Health Information Network (NHIH) standards. CMS uses the CONNECT brand of gateway. All gateways, whether the provider chooses to build their own or use a certified HIH provider must be compatible with CONNECT. More information on CONNECT can be found at http://www.connectopensource.org/.

What are the benefits of submitting documentation electronically?

  • Time efficient: Copying medical records is time consuming and costly.

  • Cost effective: esMD offers a paperless way to transmit records to save providers on postage and/or copying expenses.

  • Note: Using esMD is voluntary. Providers who prefer to mail their documentation for review may continue to do so. CMS says, providers will not be targeted for review because they use esMD.

In addition to medical documentation requests/responses, the esMD system has also began supporting the Power Mobility Devices (PMD) Prior Authorization request process.

Power wheelchairs and power operated vehicles (also known POVs or scooters) are collectively classified as Power Mobility Devices (PMDs) and are covered under the Medicare Part B benefit.

To see a list of CMS Review contractors that are accepting these transactions, click here.

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