NaviNet, the real-time healthcare communications network, has announced NaviNet Doc Xchange, which enables electronic document exchange among providers, insurers and others, reducing mail- and fax-based submission.
NaviNet Doc Xchange will be available in August as a Health Information Handler (HIH) under the first phase of the Centers for Medicare & Medicaid Services' (CMS) electronic submission of medical documentation (esMD) pilot program.
"NaviNet is eager to work with CMS to address a significant provider and insurer pain point," said John Kelly, chief information officer of NaviNet. "We believe we're uniquely positioned to increase participation in the CMS esMD program as physicians, clinicians and healthcare providers in all 50 states already use NaviNet regularly to connect with health insurers including Medicare."
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He added that NaviNet developed Doc Xchange based on its "expertise in provider office workflows." As the needs of payers and providers evolve, he says, "We see an opportunity for NaviNet Doc Xchange to support additional administrative, financial and clinical information delivery for providers, insurers and health information exchanges across the country."
CMS' esMD pilot program was developed to help providers submit medical documentation to CMS electronically, reducing cost and revenue cycle time by minimizing and eventually eliminating paper processing, mailing and faxing of medical documentation. The esMD program is designed to streamline a process that takes time away from patient care and gives providers a new mechanism for information delivery.
During Phase 1, which goes live later this summer, Review Contractors will continue to send medical documentation requests via paper mail and providers will have the option to electronically send medical documentation to the Review Contractor that requested it.
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NaviNet officials point out that providers today do not have an electronic channel to submit medical documentation to CMS or to check the status of submitted information. Mailing or faxing paper-based supplemental documentation, which is required for up to 15 percent of all claims and in the case of Medicare Recovery Audits, can cost provider offices and hospitals up to $12 and $30, respectively, per request. Further, payments to providers can be significantly delayed.
NaviNet is an HIH that uses the Nationwide Health Information Network standards, and NaviNet Doc Xchange will serve as a secure esMD gateway. Using NaviNet Doc Xchange, which integrates with third-party electronic medical records and NaviNet EMR, providers can send medical documents pulled from an EMR in a standard format or uploaded to the solution in an unstructured format (.pdf or image). NaviNet Doc Xchange also brings transparency to the documentation delivery process, officials say, as providers can determine when submissions were received and if they have been processed correctly.
NaviNet Doc Xchange will be initially available through NaviNet Insurer Connect, the multi-payer portal. The solution provides a technology foundation enabling providers to send content-agnostic medical documentation quickly and easily to a variety of trading partners: other provider offices and hospitals, insurers, government organizations, health information exchanges and more.