Medicare Documentation Requirement Lookup Service

Friday, October 19, 2018 10:47 AM | Carol Burke (Administrator)

Centers for Medicare & Medicaid Services
Special Open Door Forum:
Medicare Documentation Requirement Lookup Service
Tuesday, October 23, 2018
2:00-3:00 pm Eastern Time
Conference Call Only
 
The Centers for Medicare & Medicaid Services, Center for Program Integrity will host a series of Special Open Door Forum (SODF) calls to educate the public about a new initiative underway to develop a Medicare Fee for Service (FFS) Documentation Requirement Lookup Service prototype. Also, to allow physicians, suppliers, IT and Electronic Health Record (EHR) Developers and Vendors, and/or all other interested parties to provide feedback to CMS and inform how interested parties can get involved or track the progress of this initiative.


CMS is collaborating with ongoing industry efforts to streamline workflow access to coverage requirements, starting with developing a prototype Medicare FFS Documentation Requirement Lookup Service and is participating in two workgroups to promote development of standards that will support the Lookup Service. One workgroup is a private sector initiative hosted by Health Level Seven (HL7), the Da Vinci project. The second workgroup is The Office of the National Coordinator for Health Information Technology (ONC) Payer + Provider (P2) Fast Healthcare Interoperability Resource (FHIR) Taskforce.
 
By working with HL7, ONC, other payers, providers, and EHR vendors, CMS is helping define the requirements and architect the standards-based solutions. In parallel, CMS is preparing to support pilots testing the information exchanges for Medicare FFS programs and possibly coordinate pilots with volunteer participants to verify and test the new FHIR based solutions.


The goals of the Documentation Requirement Lookup Service prototype are to reduce provider burden, reduce improper payments and appeals, and improve "provider to payer" information exchange. The prototype will be made accessible to pilot participants and will allow providers to be able to discover the following at the time of service and within their EHR or practice management system:

  1. If Medicare FFS requires prior authorization for a given item or service; and
  2.  Documentation requirements for Oxygen and Continuous Positive Airway Pressure Devices.


For more information and to access the slide presentation for the SODF, please visit our website: go.cms.gov/MedicareRequirementsLookup.
We look forward to your participation.
Special Open Door Participation Instructions:
Participant Dial-In Number: 1-(800)-837-1935
Conference ID: 7277693


A transcript and audio recording of this Special ODF will be posted to the Podcast and Transcripts website at https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts.html for downloading.
For automatic emails of Open Door Forum schedule updates (E-Mailing list subscriptions) and to view Frequently Asked Questions please visit our website at http://www.cms.gov/OpenDoorForums/.


Thank you for your interest in CMS Open Door Forums.
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