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Submit an Appeal Electronically via esMD

CMS developed a mechanism for contractors to receive first level appeals electronically from providers via a secure gateway known as Electronic Submission of Medical Documentation, or esMD.

Some providers may be familiar with esMD, as it can also be used for submission of medical documentation in response to an additional development request (ADR) from a CMS review contractor. Any provider that wants to electronically submit medical documentation or first level appeals to a CMS review contractor must either:

  1. Build a gateway, or
  2. Procure gateway services from a Health Information Handler (HIH) of their choice

Please note that the Appeals process is not changing. Providers will continue to be required to include a complete and signed CMS-20027 Medicare Redetermination Request Form (or other acceptable form of Appeal request or letter). The first page of the submission should be the appeal request.

You can learn more about signing up for esMD and choosing an HIH on the official CMS esMD web page at: http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/ESMD/index.html

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