Announcements
- Thank you for your participation!! As of March 19th, 2012 the esMD PPA Provider Registration Use Case 1 has been finalized. The document below as well as the text embedded within the Wiki reflect updates that were proposed and agreed upon during the formal Consensus Process. Please contact the Workgroup Lead or Support Lead if you have any remaining questions or concerns.
Works Approved Through Consensus
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The esMD PPA work stream will have 2 Use Cases. The work group will initially focus on developing the first Use Case for Registration - Provider registration with payer entity to receive electronic medical documentation request. The work group will then focus on the second Use Case for the secure sending of the electronic Medical Document Request (eMDR) to Providers / Agent
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Click HERE to download printable PDF version of the PPA Workgroup Charter
Provider Profiles Authentication (PPA) Workgroup Artifacts
Edit Artifact Table
Visit the following page for information on Use Case 1 Provider Registration: UC -1 Provider Registration
Visit the following page for information on the Harmonization of Use Case 1: Harmonization UC -1
PPA Workgroup Charter
Purpose Statement
The purpose of the PPA workgroup is to evaluate solutions to:
- Register providers with CMS to receive electronic medical document request
- Support CMS and other appropriate payers in securely sending medical documentation request to HIHs/Providers
These solutions, combined with other esMD Initiative efforts, will enable CMS Review Contractors to send electronic medical document request letters, as an alternative to current paper processes.
Objective
Define the business requirements related to the registration process, compliant with CMS policies and FISMA guidelines, and determine how to securely send medical document request letters to registered providers. In addition to addressing requirements, this workgroup will also analyze and harmonize standards to support secure electronic sending of medical document request letters. Business requirements and standards will have a key focus on the needs of CMS and the CMS post-payment Review Contractors, while also considering options to enable re-use of the processes and standards by other Payers and Medicare partners.
Priority within the esMD Initiative
- Highest Priority - This is a basic requirement needed for the esMD Phase 2 targeted for Fall 2012
In Scope
- CMS esMD Signup/Registration process
- Requirements and standards pertaining to technical transport and authentication needed to allow CMS/Payers to send medical document request letter to specific providers, either directly or via HIH
Out of Scope
- Structure of medical document request letter will be covered in Structured Content workgroup
- Authentication of content sent from Providers will be covered in the Author of Record workgroup
Related Policies
Dependencies
- Input from PD Use Case #2
- Exchange support for secure transport and other infrastructure
Relevance outside of CMS-esMD
- Registration Process following FISMA requirements might be used by other Federal agencies and payers
- Mechanisms/standards to send medical request letter might be used by Payers
Related Workgroups
- Within S&I: Provider Directories, Use Case Simplification
- External to S&I: TBD
- Within CMS: No other current work related to Trading Partner Profile
esMD Phases and Timeline
Below is an explanation of the focus of the PPA Workgroup. We are currently working on Phase 2.
Image AddedesMD_Phases.JPG
Below is a tentative timeline for the completion of artifacts for Use Cases 1 and 2 for PPA workgroup as well as an estimated time frame to begin work on the Structured Content Workstream.
Image AddedesMD_PPA_timeline.JPG
Works in Progress
All items below are artifacts associated with PPA Use Case 2 - Sending of eMDR and Structured Content of the eMDR
All Items below are artifacts associated with PPA Use Case 1 - Provider Registration with a Payer to receive eMDR
Artifact Name | Description/Purpose | Current Status | Status | Target Date for Completion |
PPA Use Case 1 - Final Artifact | Final Consensus approved Use Case and Functional Requirements | CLOSED | Consensus Approved | 3/19/2012 |
Parking Lot for PPA Use Case | All items removed from any sections from the Use Case to be used at a later time are captured here. | CLOSED | Use Case Team to update as necessary | NA |
Glossary of Terms | This page will house all descriptions of terms and definitions used for all esMD work streams | CLOSED | Update as necessary | |
PPA Updated Context Diagram - User Stories | Draft Updated Context diagram as of 12/14 | CLOSED | Drafted for review on 12/14 meeting. | 12/20/11 |
PPA User Story 1 - Registration | Draft User Story 1 Write up | CLOSED | Drafted by participants to be reviewed by Community for 1/4 meeting | COB 1/10/12 |
PPA Actors and Roles | Draft Actors and Roles Table | CLOSED | Drafted by Use Case Team; Community to Review | COB 1/25/12 |
PPA Assumptions, Pre and Post Conditions | Draft Assumptions, Pre-Conditions and Post-Conditions | CLOSED | To be drafted by community for review during 1/4 meeting | COB 1/25/12 |
PPA UC 1 - Activity Diagram, Base Flow and Sequence Diagram | Draft Activity Diagram, Base Flow, and Sequence Diagram for Provider Registration | CLOSED | Drafted by Use Case Team; Community to Review To be drafted by community for review during 1/4 meeting | COB 1/25/12 |
CMS User Story | CMS focused User Story and associated UC Sections | CLOSED | Drafted during 1/20/12 working group meeting | COB 2/3/12 |
Commercial Payer User Story | Commercial Payer focused User Story and associated UC Sections | CLOSED | Open for community review | COB 2/10/12 |
Functional Requirements | Outlines Functional Requirements - Information Interchange and System Requirements. Also includes Data Set considerations. | CLOSED | Started discussions on 1/25/12 | COB 2/10/12 |
Risks, Issues and Obstacles | Lists the concerns that might interfere with meeting the requirements of the Use Case. | CLOSED | Draft reviewed during 2/8 meeting. | COB 2/15/12 |
Communities of Interest | Stakeholders and Interested parties | CLOSED | Draft reviewed during 2/8 meeting and to be continued at future meeting | COB 2/17/12 |