Recovery auditor hot topics: esMD
Recovery Auditor Report, March 8, 2012
The following article is part one in a series covering various topics in the world of recovery auditors. Part one will focus on CMS’ esMD (Electronic submission of medical documentation) program.
A year ago this month, CMS announced its esMD tool, which is an option for providers to electronically send medical documentation that is requested of them by recovery auditors and other government entities contractors. This article will take a look at the advances the esMD program has made since then, and what providers should expect of it going forward.
Who is accepting esMD?
Phase 1 of esMD kicked off on September 15, 2011, and during this period, providers will still receive medical documentation requests via paper mail, but will have the option to electronically send their documentation to the requesting review contractor. As of September 2011, the following review contractors have been approved to participate in the esMD program:
- Region A Medicare recovery audit (DCS)
- Region B Medicare recovery audit (CGI)
- Medicare administrative J1 (Palmetto GBA)
- Medicare administrative J3 (Noridian)
- Medicare administrative J4 (Trailblazer)
- Medicare administrative J5 (WPS)
- Medicare administrative J9 (First Coast)
- Medicare administrative J11 (Palmetto)
- Medicare administrative J12 (Highmark)
- Medicare administrative J14 (NHIC)
- Comprehensive error rate testing (CERT) contractor
- Program error rate measurement (PERM) contractor
- DME Medicarea JA (NHIC)
- DME Medicare administrative JD (Noridian)
- Medicare administrative J13 (NGS)
- DME Medicare administrative JB (NGS)
- Medicare administrative J10 (Cahaba)
Region D recovery auditor HealthDataInsights plans to participate in the program starting this month, and Region C recovery auditor Connolly next month.
Related Products
-
Core Skills for Hospital Case Managers:
A guide to fundamental case management responsibilities, Core Skills for Hospital Case Managers serves as a training...
-
The RAC Toolkit for Hospitals and Health Systems
The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program is your...
-
The 2013 Medicare Compliance Forum: Las Vegas, NV
-
Level of Care Determinations for 2014: Las Vegas, NV
Attend the half-day seminar, Outpatient, Observation or Inpatient? Continuing to Walk the Tightrope of Regulatory Guidance...
-
OPPS and IPPS Reimbursement Fundamentals: Las Vegas, NV
Attend OPPS and IPPS Reimbursement Fundamentals, a half-day seminar on October 2nd in Las Vegas. Learn how CMS’ substantial...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Practice the six rights of medication administration
- Complications from immobility by body system
- Prevent dehydration with nursing interventions
- Note similarities and differences between HCPCS, CPT® codes
- The consequences of an incomplete medical record
- Know guidelines and subtle differences in code descriptions for laceration repairs
- Q&A: Primary, principal, and secondary diagnoses
- Skills of effective case managers
- Neurological checks for head injuries
- E-mailed
-
- Performing a SWOT analysis
- Unsuccessful v. aborted/discontinued procedures
- Q/A: Infusions in an interosseous line
- Nine ways to meet USP 797, get ready for your next survey
- Hospital Billing from A to Z: 3- and 1-day rules
- Don't bill 59025, 76818 separately without separate physician orders
- Documentation challenges for skin and dermatology coding
- Searched
