Electronic Submission of Medical Documentation (esMD)

Noridian accepts Medicare's Electronic Submission of Medical Documentation (esMD) transactions from providers responding to Additional Documenation Requests (ADRs).The intent of esMD is to

  • Reduce provider costs and cycle time by minimizing and eventually eliminating paper processing and mailing of medical documentation to review contractors.
  • Reduce costs and time at review contractors.

In order to send medical documentation electronically to review contractors, Medicare Part B providers must obtain access to a CONNECT-compatible gateway.

  • Certain larger providers, such as hospital chains, may choose to build their own gateway.
  • Many providers may choose to obtain gateway services by entering into a contract or other arrangement with a Health Information Handler (HIH) that offers esMD gateway services.

A list of HIHs that offer esMD services can be found at http://go.usa.gov/krg. The listing is updated with HIHs that have been approved by CMS to offer esMD services. CMS and Noridian do not set the price that an HIH may charge a provider for esMD services. Providers who believe it may be more efficient to respond to documentation requests electronically are encouraged to contact one or more of the HIHs to determine if esMD services are available at a reasonable price. esMD is completely voluntary.

Providers are not required to submit their medical documentation using esMD. Providers may continue to mail or fax documentation to Noridian. Additionally, neither CMS nor Noridian will provide reimbursement for any cost or fees for esMD.

Resources

 

Last Updated Oct 08, 2018