The Centers for Medicare and Medicaid Services expects on August 1 to start a pilot program to accept electronic attachments that support submitted claims.

Under the pilot, providers--who normally fax or mail clinical documentation to support claims to Medicare Audit Contractors and Recovery Audit Contractors--can use selected health information vendors to electronically transmit requested information.

Seven health information technology vendors are on tap to support the esMD Gateway Services program starting in August: EHRDOCTORS, HealthPort, Health IT Plus, IVANS, MRO Corp., NaviNet Inc. and RISARC Consulting.

Other vendors expected to join in October include AKIRA, eSolutions Electronic Commerce, BACTES, Secure Exchange Solutions, Cobius, Greenway Medical Technologies, IOD, Proficient Health, Craneware, AT&T and Medical Electronic Attachment.

The pilot starting in August is a first-phase test during which Medicare's contractors will continue to send documentation requests via postal mail and providers will have the option of electronically sending the information. During Phase 2, starting in 2012, contractors will electronically send the documentation requests in addition to electronically receiving the materials.

Participating vendors will build and use "esMD gateways," compatible with the federally developed Connect downloadable health information exchange software. For vendors, such as Boston-based NaviNet that operates Web portals enabling providers to exchange administrative and financial transactions with insurers, the pilot is an opportunity to significantly enhance services.

NaviNet clients are able to transmit some clinical information to insurers by adding the information in a memo field. Clients participating in the pilot program additionally will be able to transmit original clinical documents as PDF or TIFF image files, and archive and track the status of the request and response. In a later phase, they'll be able to transmit structured clinical data.

More information on the esMD Gateway Services program, including a schedule of when contractors will start participating in the pilots, is available at cms.gov/esMD.

 

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