1. Electronic Submission of Medical Documentation (esMD) Initiative Breakout Session Wednesday, April 11 th, 2012 3:00 PM – 6:00 PM 1

2. esMD F2F Kickoff Agenda 2 Topic Presenter 1Introduction of esMD Support Team Sweta Ladwa 2Initiative Overview of esMD, Workgroups, and relevant Use Cases Sam Elias 3esMD Initiative Timeline Sam Elias 4esMD Accomplishments Sam Elias 5esMD F2F Objectives and Goals Sam Elias SSchedule for esMD F2F Meetings Sam Elias 7F2F Logistics Sweta Ladwa

3. Support Team Members Initiative Coordinator – Sam Elias CMS Representative - Dan Kalwa Workgroup Co-leads – Bob Dieterle, Mark Pilley Project Management Support – Sweta Ladwa, Adjoa Degbo Use Case Support– Emily Mitchell, Presha Patel Harmonization Support – Will Ryan, Shay Paintal Standards Development Support – Anna Langhans, Saunya Williams Administrative Support – Marcus Imes-Keys, Sallie Miller Introduction of Community Members 3

4. esMD Initiative Purpose and Scope Initiative Purpose – To enable the electronic delivery of medical document request letters from payer entities to providers, and identify author-level signature solutions needed to enable acceptance of electronic claims attachments. Scope – Define the requirements and select the electronic standards necessary to replace current paper processes for medical documentation requests with an electronic alternative. 4

5. esMD Workgroups Discusses the registration process, technical transport and authentication needed to allow Payers to identify Providers and send requests to them. Dependent on the Provider Directories Use Case #2 (Electronic Service Information Discovery) outputs, as well as the Exchange support (for the CMS User Story) for secure transport and other infrastructure. Provider Profiles Authentication (PPA) workgroup: Determine the structured electronic format of medical document request letters to be sent to Providers Determine the technical transport, expected response, and fields needed to support the response Structured Content (SC) workgroup : Evaluate the business needs and discuss implementable solutions to prove the authorship and authenticity of any medical documentation submitted in response to a payer or contractor request Author of Record (AOR) workgroup 5

6. Use Cases within each esMD Workgroup Use Case 1 – Provider Registration with a Payer entity to receive electronic Medical documentation Requests (eMDRs) Use Case 2 – Secure Transportation and Structured Content of the eMDRs from Payer to a registered eMDR Consumer Provider Profiles Authentication The outputs of this workgroup are a set of data elements and requirements for the content of the eMDR itself. This workgroup’s outputs will be incorporated into PPA Use Case 2 Structured Content The workgroup will begin discussion on development of this Use Case once PPA Use Case 2 has been completed Author of Record 6

7. esMD Initiative Timeline 7 7 Author of Record WG Use Case and Requirements Pilots (TBD) Harmonization SDS Structured Content WG Use Case #2: Sending eMDR Outline Use Cases & Stories Harmonization/ Standards Analysis of Registration (Use Case #1) Harmonization/ Standards Analysis of eMDR (Use Case #2) Use Case #1: Registration Discovery Implementation Pilot Combined Registration/ eMDR Pilots 11/30-12/7 Charter Consensus Pre-Discovery Initiative Charter/Scope Today (4/11/12) Oct ‘11 Kick-Off/ F2F Oct ‘12 Jan ‘12April ‘12 July ‘12 PPA Workgroup Target Initiative Completion: Oct ‘12

8. Accomplishments to Date Achieved Consensus on PPA Use case 1 focusing on provider registration with a payer to receive electronic medical documentation requests (eMDRs) (March 19 th, 2012) – Currently working on initial Harmonization activities for PPA Use Case 1. (All Harmonization activities for both Use Case 1 and 2 will be completed together) – We’re two-thirds of the way through in creating the data model for Use Case 1 Completed drafting various sections of PPA Use Case 2 sections focusing on – Secure Transportation of the eMDR from payer entities (CMS or commercial payers) to a registered provider Generic User Story, Assumptions, Pre and Post Conditions, Actors and Roles, Activity and Sequence Diagrams, Base flow of information, Functional Requirements and Dataset Requirements – Structured Content of the eMDR from payer entities (CMS or commercial payers) “ Cover letter” portion of the eMDR 8

9. F2F Objectives and Goals Use Case – Complete drafting and review of all PPA Use Case 2 sections for end-to- end review by: Reviewing remaining sections for PPA Use Case 2: Reviewing Dataset Requirements for the contents of eMDR Harmonization – Complete initial Harmonization of the PPA UC 1 data elements identified for ‘Registration Request’, ‘Registration Response’ and the relevant ‘Data Objects’ 9

10. F2F Schedule 10

11. F2F Logistics Information regarding maps, schedules for the F2F, restaurants, hotel shuttle, etc. can all be found at the registration desk If you have any issues or questions while at the F2F, please let Sweta Ladwa or Presha Patel know– we’ll be glad to help! 11

12. Thank You The esMD support staff and coordinators want to thank you for all the hard work you’ve put in to esMD so far, and for taking the time to attend the S&I Framework F2F meeting. We look forward to a meaningful and productive meeting! 12