Electronic submission pilot aims to reduce costs for healthcare providers

The Centers for Medicare and Medicaid Services’ (CMS) electronic submission of medical documents (esMD) pilot scheme could allow Medicare review contractors to deliver data electronically, reports Information Week. This system may prove to be more cost-effective than existing methods.

The scheme aims to permit healthcare providers to submit data to review contractors through one of seven third-party health information handlers (HIH). NaviNet, HealthPort and RISARC have all begun development of esMD gateways, according to the CMS. An additional 11 healthcare IT companies have applied to become HIHs, including AT&T, Craneware, Proficient Health and Greenway.

The esMD pilot is structured into two phases. During phase one, CMS review contractors will continue to send requests for supporting documentation to healthcare providers by fax and mail, and clinicians will have the option of submitting the data electronically.

Phase one is due to commence in August. Phase two, which will go live in 2012, will enable review contractors to send requests to healthcare professionals electronically.

CMS spokesman Joseph Kuchler told Information Week that “the primary intent of the esMD program is to reduce provider costs and administrative costs by minimizing paper processing and mailing of medical documentation to Medicare and Medicaid review contractors.”

According to the CMS, the review contractors who are participating in the esMD pilot include the Recovery Audit Contractor, the Medicare Administrative Contractor, Comprehensive Error Rate Testing contractor and Program Error Rate Measurement Contractor. Zone Program Integrity Contractors are expected to join the program in October 2011.

Information Week reports that NaviNet will implement its Doc Xchange software to send healthcare provider data through the open source CONNECT gateway. The news outlet further states that Laurance Stuntz, NaviNet’s senior vice president of product integration, estimates that healthcare providers could save, on average, $100 per provider per month by submitting records to the CMS electronically.