CMS Research, Statistics, Data & Systems- Electronic Submission of Medical Documentation (esMD)- esMD for Health Information Handlers
Guidance for CMS Research, Statistics, Data & Systems regarding Electronic Submission of Medical Documentation (esMD) for Health Information Handlers.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: September 23, 2020
Health Information Handlers (HIHs) can provide software and communication services to help providers and suppliers securely exchange documentation with Review contractors using the Electronic Submission of Medical Documentation (esMD) System.
- Build a compliant and CONNECT-compatible gateway
- Use Reference Implementation and Outreach Coordinator (RIOC) software.
Refer to slides 14 and 15 of the Introducing esMD to New Providers, RCs, and HIHs (PDF) for more details.
CMS recommends that HIHs ensure they have an experienced technical staff to expedite all testing tasks and review the esMD HIH Implementation Guide (PDF) and the X12 Transaction Companion Guide and Codes (PDF). Knowledge of CONNECT software and the Simple Object Access Process (SOAP) User Interface (UI) tool is also helpful.
Current Release Documents
Release specific documents that are sent via notification by the esMD Help Desk will also be published on the website. The esMD technical team distributes the following documents during the course of the release:
Current Release Information (October 2021 Release)
- Release Summary Document (PDF)
- HIH Preliminary Technical Release Changes (Notification 815, sent 9/29/2021) (PDF)
Note: This section will have the documents for the upcoming release. After updates are available, all documents related to that release will be removed as all the details will become part of the HIH Implementation Guide (PDF).
Contact the esMD Help Desk for additional assistance.
View the Program Integrity Manual Section 22.214.171.124 – “Additional Documentation Request Required and Optional Elements” (PDF) in addition to the associated Program Integrity Manual Exhibits 46.1 – 46.5 (PDF).
Frequently Asked Questions
Download and submit the Change Request – Certificate Renewal Form (PDF).
CMS is using CONNECT version 4.4 in its current release of the CMS esMD gateway.
Find guidance on Claim ID format on Page 25 of the HIH Implementation Guide (PDF).
All the details related to the X12 (278/275) transactions can be found in various companion guides and documents.
The best way to address issues with esMD is to create an incident ticket with the esMD Help Desk.
Visit Medicare Fee-for-Service Compliance Programs for more information.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.