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Which HIHs Offer esMD Gateway Services to Providers?

What is a Health Information Handler (HIH)?
Any organization that handles health information on behalf of a provider is an HIH. Many providers already use HIHs to submit claims, provide electronic health record systems, etc. These HIHs are often called claim clearinghouses, release of information vendors, Health Information Exchanges, Electronic Health Record vendors, etc. Some HIHs are beginning to offer Electronic Submission of Medical Documentation (esMD) gateway services as well.

Which HIHs have been CERTIFIED by CMS to offer esMD gateway services to providers?

HIH Name Has been certified by CMS to offer the following esMD services
Send Response to Medical Documentation Request in PDF to Review Contractor Send PMD Prior Authorization Request in PDF to Review Contractor Receive PMD Prior Authorization Review Results Message from Review Contractor Send Structured Progress Notes to Review Contractor Send Structured Orders to Review Contractor
ApeniMed January 2012   01/07/13 Not Offered Not Offered Not Offered
Cobius February 2012   Not Offered Not Offered Not Offered Not Offered
Craneware August 2012 Not Offered Not Offered Not Offered Not Offered
eSolutions January 2012 02/21/13 6/17/13 Not Offered Not Offered
Health IT Plus November 2011 01/07/13 Not Offered Not Offered Not Offered
HealthPort September 2011 Not Offered Not Offered Not Offered Not Offered
IOD January 2012 Not Offered Not Offered Not Offered Not Offered
ABILITY Network\IVANS September 2011 01/08/13 2/16/14 Not Offered Not Offered
LOISS November 2012 Not Offered Not Offered Not Offered Not Offered
Medical Electronic Attachment (MEA) January 2012 01/07/13 Coming Soon Not Offered Not Offered
MedFORCE Technologies December 2012 02/04/13 Not Offered Not Offered Not Offered
MRO October 2011 Not Offered Not Offered Not Offered Not Offered
Proficient Health May 2012 01/29/13 Not Offered Not Offered Not Offered
RISARC September 2011 01/07/13 10/07/13 Not Offered Not Offered
Rycan Technologies Inc. July 2012 Not Offered Not Offered Not Offered Not Offered
SSI May 2012 Not Offered Not Offered Not Offered Not Offered
SunCoast RHIO Inc. October 2012 Coming Soon Coming Soon Not Offered Not Offered
Verisk Health (formerly MediConnect) August 2012 Not Offered Not Offered Not Offered Not Offered
Verisma Systems, Inc. April 2013 Not Offered Not Offered Not Offered Not Offered
Bluemark July 2013 Not Offered Not Offered Not Offered Not Offered
Medical Records, LLC August 2013 Not Offered Not Offered Not Offered Not Offered
Dorado Systems August 2013 Not Offered Not Offered Not Offered Not Offered
Episode Alert August 2013 Not Offered Not Offered Not Offered Not Offered

Blue = Service offered by HIH.
Gray = Service not offered by HIH at this time or service not available through CMS Gateway at this time.
Coming Soon = Looking to offer services.

The following HIHs have entered into a partnering agreement with a certified HIH, and have started to market esMD gateway services to providers with their own brand name:

  • CM Information Specialists
  • ECC Technologies' RAPID Network
  • Fastrack Healthcare Systems
  • Medi-Copy Services, Inc
  • ScanSTAT Technologies
  • The Wellington Group, LLC
  • Wolters Kluwer Law & Business
  • Compliance 360, an SAI Global Company

Can other HIHs offer esMD gateway services to providers?
Any health information handler (HIH) that meets the following criteria can participate in the esMD program:

  1. The HIH has a contract with one or more Medicare providers to handle their health information,
  2. One or more of the HIH's providers have received a medical documentation request from a Medicare Recovery Auditor or MAC,
  3. The HIH has built or is building a CONNECT-compatible gateway,
  4. The HIH is willing to obtain an identity certificate and communicate that certificate key to the CMS esMD gateway contractor and ONC contractor.

HIHs that would like to become an esMD HIH, click the link at the left called "Information for Prospective HIHs".

Does CMS pay esMD HIHs?
No.

Does CMS contract with esMD HIHs?
No.