Empire Medicare Services (EMS) is pleased to announce the availability of a new electronic service for our providers. EMS is now offering the electronic delivery of the Part A Additional Development Requests (ADRs) and the Part B letters from the Automated Development System (ADS) via the 277 V4050 Health Care Claim Request for Additional Information. This new service is available to our institutional providers supporting the file transfer protocol (FTP) process and to our medical providers via FTP and e-Link. Why should you take advantage of this new service? Currently, most ADRs and all ADS letters are delivered on paper via regular mail (commonly referred to as “snail mail”). For Part A providers, those that are not delivered via mail require access to the FISS/DDE system to screen-print the requests. Receiving the electronic 277 transaction gives providers almost immediate access to these requests rather than having to wait for “snail mail” delivery of the paper requests. This results in additional time for providers to respond to the requests and can assist in eliminating the instances of “lost” requests. The 277 transaction can be electronically forwarded to the specific departments required to respond. Ultimately, providers can significantly reduce the number of claims rejected for untimely response because of “lost” paper requests. What is required to take advantage of this new service? Providers must have the capability to translate the 277 V4050 Health Care Claim Request for Additional Information transaction set. The implementation guide can be obtained from the Washington Publishing Company Web site: www.wpc-edi.com Do you want to take advantage of this service, but can’t immediately support the 277 V4050 transaction set? While EMS is implementing the electronic request for additional information, we are not, at this time, implementing the electronic medical record response. What this means is that providers will be required to return a hardcopy of the ADR/ADS with the requested medical record information. To facilitate this process, EMS is supplying our providers with an additional file to download. This file is a print file of the ADR or ADS letter which must be printed and returned with the requested medical records. The ADR/ADS letter contained in the print file will look identical to the hardcopy version that is currently mailed to providers. While providers are developing the process to take full advantage of the 277 transaction set, providers can begin to reap some of the benefits by taking advantage of the electronic print file to receive their additional development requests. If you are currently receiving hardcopy ADR or ADS letters from EMS, we encourage you to consider this new electronic service. For more information regarding this new service, contact the IES Help Desk at 1-866-889-7322. Posted: 11/07/2006 CPT codes, descriptions, and other data only are copyright 2006 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.
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. There is a charge for download of this guide. The 277 transaction set will use the Logical Observation Identifier Names and Codes (LOINC) to identify the medical documentation request. These codes are available free-of-charge from the HL7 Web site:
