Health Information Handler.
Secure electronic transmission of documentation between providers and CMS review contractors through Digital HIE's HIH and esMD-enabled Gateway.
CMS-ready HIH enablement
As a Health Information Handler, Digital HIE provides secure electronic transmission of data among healthcare entities to improve care coordination and outcomes.
Our HIH solution can receive claims information in any format and submit it to CMS. Digital HIE Gateway accepts custom CSV, XML, or flat files as well as standards-based HL7 v2.x, HL7 FHIR, and EDI X12 files, then transforms the data for CMS esMD processing.
The Gateway is hosted in a secured GovCloud environment with FedRAMP-aligned security controls protecting data at rest and in transit, including CUI, PII, and sensitive medical documentation.
Need for Additional Documentation
- Medicare Fee-For-Service programs face significant estimated improper payments.
- Review Contractors sample claims and request medical documentation from providers.
- Traditional ADRs arrive as paper letters, with responses by mail or fax.
- esMD provides a secure electronic channel between providers and Review Contractors.
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.
What providers can send and receive
Digital HIE HIH provides a secure electronic channel for exchanging information between the provider community and review contractors. Gateway support for esMD transactions helps providers and hospitals get paid sooner.
Providers can send
- 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
Providers can receive
- Prior Authorization Responses
- Electronic Medical Documentation Requests (eMDRs)
Benefits of Using HIH
Get paid sooner
According to the CMS esMD Program, providers have reported payment turnaround of about 6 days using esMD, compared with approximately 3 to 4 weeks with traditional paper processes.
Reduce labor cost
Eliminate printing, mailing, faxing, or burning CDs. Digital HIE HIH accepts existing formats and converts them for CMS esMD requirements.
Lower hard costs
Save shipping and handling expenses, and reduce hardware and infrastructure overhead by using Digital HIE HIH.
Enable electronic medical documentation exchange
Talk with Digital HIE about HIH onboarding, Gateway connectivity, and CMS esMD workflows.