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:

1. Register providers with CMS to receive electronic medical document request
2. 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

• FISMA

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