Electronic Submission of Medical Documentation
Medicare’s Electronic Submission of Medical Documentation (esMD) pilot project gives providers an option to use a new mechanism for submitting medical documentation when CGS requests it via the Additional Development Request (ADR) process.
The esMD pilot project is completely voluntary. You may continue to follow the current ADR process.
If you wish to begin sending ADR information electronically via the esMD, you must obtain access to a CONNECT-compatible gateway. Providers may choose to build their own gateway; however, you may enter into a contract or other arrangement with a Health Information Handler (HIH). A list of HIHs that offer esMD services can be found at http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/ESMD/Which_HIHs_Plan_to_Offer_Gateway_Services_to_Providers.html on the Centers for Medicare & Medicaid Services (CMS) website.
Providers using the esMD process should ensure that CGS’s contractor number, 15004 (for home health and hospice providers), is clearly marked on the first page of your documentation. This will help to ensure that your documentation is routed to the CGS staff responsible for the home health and hospice documentation. In addition, providers can confirm CGS’s receipt of their esMD documentation by monitoring the claim using the Fiscal Intermediary Standard System (FISS) Option 12. Once esMD documentation is received, the claim will be moved from status/location S B6001 to S M50MR within 7 days of receipt.
Additional Resources
- SE1110—Medicare Pilot Project for Electronic Submission of Medical Documentation (esMD)
- Electronic Submission of Medical Documentation (esMD) Overview webpage
Updated: 11.16.12
