Your esMD Vendor Just Left — How to Avoid Downtime in Your Submission Process
When an Electronic Submission of Medical Documentation (esMD) vendor leaves the market, the clock starts ticking for healthcare systems reliant on that technology. Medicare/Medicaid audit requests and additional documentation requests do not pause while you search for a new submission method. If you miss the 45-day Centers for Medicare & Medicaid Services (CMS) window for returning records, the result can be payment delays, denials, and costly rework.
This scenario may be playing out for providers who relied on vendors who are sunsetting support for esMD records. With an interface no longer supported, organizations without their own Application Programmable Interface (API) or User Interface (UI) connection to CMS are now asking, “What do we do next?”
As Robert Taylor, Vyne Medical’s Senior Product Analyst, explains:
“They don’t have a development team to build a FHIR API connection. They’re looking around to figure out who can satisfy their request as of today.”
Why Vendors Exit and What It Means for You
Some vendors step away from esMD because maintaining the CMS CONNECT gateway code is costly and complex. When support ends, no new CMS updates are applied. While the system may still operate for a time, the lack of updates increases the risk of compatibility issues.
For providers, this means:
- No guarantee that submissions will process without error in the future
- No ability to take advantage of newer features like Electronic Medical Documentation Requests (eMDR)
- Risk of falling back to paper, CDs, or other manual processes
Steps to Keep Your Submission Process Running
- Assess Current Requests
Inventory all pending Medicare audit and additional documentation requests. Identify which are time-sensitive and confirm their due dates. - Notify CMS if Needed
If your vendor change affects how you receive eMDR request letters, update your NPI registration in the CMS portal so new letters can be routed to your chosen Health Information Handler (HIH). - Use a Secure Interim Method
If a new esMD platform is not yet live, use a delivery method such as Vyne Medical’s Cloud Fax Solution, compliant with medical industry regulations i.e., HIPAA, to send records to CMS contractors. This can prevent missed deadlines during the transition.
What to Look for in Your Next esMD Partner
Replacing an esMD vendor is a chance to upgrade your process, not just swap tools. Based on industry experience, here are core capabilities to prioritize:
- Certified HIH connectivity for secure, compliant transmission to CMS.
- Support for eMDR so request letters arrive electronically, not just by mail.
- User-friendly interface for staff who submit records directly.
- Integration options with EMRs and other document sources.
- Automation tools to reduce manual file preparation and indexing.
- Tracking for delivery, reviews, and decisions.
Taylor notes that Vyne Medical’s Refyne® esMD solution offers implementation in as little as one to two weeks for UI customers, with the ability to let vendors utilize the API as well.
Real-World Impact: Faster Turnaround, Lower Costs
Boca Raton Regional Hospital, where more than 65 percent of patients are on Medicare, replaced its paper process with esMD and reduced payment turnaround from up to four weeks to as few as six days. The hospital eliminated paper, shipping, and labor costs, leading to an estimated $3 million in savings.
Moving Forward Without Downtime
Vendor changes can cause uncertainty, but they do not have to halt your Medicare documentation processes. By acting quickly, using an interim secure delivery method, and selecting a partner that can scale with your needs, you can maintain compliance and improve efficiency.
“What solution can they get up and running quickly… without having to go back to that archaic method of mailing their records?” Taylor asked during a recent discussion.
The answer lies in choosing a stable HIH with the right technology foundation.
If your esMD vendor has left the market, Vyne Medical has a 20+ year relationship with CMS as a Health Information Handler (HIH) and can help you avoid downtime and prepare for future requirements. Contact us to learn more.