What you need to know about new Electronic Medical Documentation Requests (eMDRs).

Frequently Asked Questions

What is eMDR?

The Centers for Medicare & Medicaid Services (CMS) is introducing Electronic Medical Documentation Requests (eMDRs) to deliver Additional Documentation Requests (ADRs) to providers electronically.

As a Medicare-certified Health Information Handler (HIH), Inovalon will provide the registration and receipt of eMDRs.

How does esMD differ from eMDR?

The Electronic Submission of Medical Documentation (esMD) is the CMS system created for providers to submit medical documentation (ADR, RAC, Appeals) electronically.

Whereas, eMDR utilizes esMD capabilities to ensure secure receipt of ADRs electronically; customers must utilize the same Health Information Handler (HIH) for both eMDR and esMD.

Providers must register for eMDRs through NPPES and with their HIH. If a provider registers for eMDRs, when CMS sends ADRs to providers, it will use eMDRs.

What are the advantages for providers to receive eMDRs?

• Electronic ADR letter (as eMDR) reaches the provider faster and brings traceability to the exchange
• ADRs received electronically enable more efficient processing and response times

When is this transition happening?

Providers can start registering in NPPES now. Inovalon is committed to ensuring a seamless and successful eMDR registration and transmission process. We are piloting with CMS prior to rolling out this new process with our customers, and we will be ready for all eMDR components early in 2020.

What do you need to do?

Providers are not required to participate in eMDR today. However, in order for eMDR transmissions to start you must register and there are two registration processes:

• One with CMS through NPPES
• One with your HIH Inovalon

Following registration, there will be three additional paper ADRs, then all subsequent ADRs will be sent electronically.

Registration steps:

    1. Gather ABILITY Network’s HIH information
    2. Log into NPPES
    3. Register one, many, or all NPIs with ABLITY Network
    4. Notify Inovalon you have registered for eMDRs
    5. Partner with Inovalon to ensure Inovalon has all necessary enrollment information
    6. Inovalon will register your NPIs for eMDRs

Here is the information you need to register in NPPES with Inovalon (formerly ABILITY Network):

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