Health Information Handler
As a Health Information Handler, we provide secure electronic transmission of data among different healthcare entities, ensuring improved care coordination and outcomes.
Digital HIE is now a HIH (Health Information Handler). Our HIH Solution is capable of receiving claims information in any format and submit to CMS.
Digital HIE Gateway can receive information in custom format in CSV or XML or Flat file and/or standards based HL7 V2.x , HL7 FHIR, EDI X12 files to extract the data and transform to data acceptable by CMS esMD system.
Digital HIE Gateway is hosted in a secured GovCloud environment with FedRAMP security enabled. We have incorporated high security controls to protect the data at rest and in transmission. From Controlled Unclassified Information (CUI), Personally Identifiable Information (PII), sensitive patient medical records, and financial data to law enforcement data, export controlled data and other forms of CUI, AWS GovCloud (US) Regions can help customers address compliance at every stage of their cloud journey.
Digital HIE Gateway supports all the esMD transactions, helps Providers and Hospitals to get paid as soon as possible without any delays.
Need for Additional Documentation:
- Medicare Fee-For-Service (FFS) Program makes billions of dollars in estimated improper payments.
- CMS employs several types of Review Contractors (RCs) to measure, prevent, identify, and correct these improper payments.
- RCs find improper payments by selecting a small sample of claims, requesting and reviewing medical documentation from the provider.
- RCs request medical documentation by sending a paper letter to the provider called – Additional Documentation Request (ADR).
- Provider responds with the appropriate documentation –ADR response via Mail/Fax.
- esMD (Electronic Submission of Medical Documentation) was introduced as a secure electronic communication channel for the exchange of supporting documentation between the Providers and RCs.
Key Services
- Direct Messaging: Secure email communication for health information.
- Interoperability Solutions: Seamless data exchange across different systems.
- Compliance: Adherence to HIPAA and other regulatory standards.
- Support and Maintenance: Ongoing support for all services.
ESMD Overview:
Digital HIE HIH is an esMD Solution (Electronic Submission of Medical Documentation) provides a secure and electronic channel for the exchange of information between the provider community and the review contractors.
Medicare Fee-For-Service (FFS) providers and suppliers can send the following via Digital HIE HIH:
- Response to Additional Documentation Requests (ADRs).
- First and Second level appeal requests.
- RAC and DME discussion requests.
- Advanced Determination of Medicare Coverage (ADMC) requests.
- Unsolicited claim related documentation.
- Prior Authorization (PA) requests along with supporting documentation.
Medicare Fee-For-Service (FFS) Provider and Suppliers can now receive the following via Digital HIE HIH:
- Prior Authorization Responses.
- Electronic Medical Documentation Requests (eMDRs)
Benefits of Using HIH
Review contractors conduct improper payment reviews to identify, correct, and prevent payment errors. They do this by selecting a small sample of claims to verify provider compliance with Medicare rules. Digital HIE HIH streamlines this process by enabling providers and suppliers to submit requested documentation electronically to CMS via esMD, offering the following benefits:
Do you want to get paid soon?
According to the CMS esMD Program, providers have reported a payment turnaround of just 6 days using esMD, compared to approximately 3 to 4 weeks with the traditional paper process.
Do you want to save $$$?
According to the CMS esMD Program, providers and suppliers can significantly reduce labor costs by eliminating the need to print, mail, fax, or burn CDs for document submission. With Digital HIE HIH, they can save costs effortlessly, without extra effort in formatting data or dedicating additional resources. Our HIH seamlessly accepts data in any existing format and converts it to meet CMS esMD system requirements for processing.
Do you want to save more $$$?
Using CMS esMD providers, suppliers can save hard costs like shipping and handling expenses. Additionally by utilizing Digital HIE HIH, the hardware and infrastructure costs are saved as well.