Livanta National Medicare Claim Review Contractor

Submission of Medical Records

Attention all providers: Final Rule CMS-1735-F effective October 1, 2020 requires healthcare providers to send records electronically to the Beneficiary and Family Centered Care - Quality Improvement Organization (BFCC-QIO). Livanta offers several options for electronic submissions, including Direct Secure Messaging (DSM), direct upload through the online e-LiFT portal, and esMD.

If you are unable to use one of these methods to submit medical records to Livanta, please call Livanta’s technical assistance line at 240-712-4300 x 2998.

Electronic Transmission

Livanta accepts medical records electronically in three ways. Providers may choose which method is best for them and submit medical records accordingly.

  1. Direct Secure Messaging: Direct Secure Messaging can be performed through many electronic medical record (EMR) systems. To clarify, Direct Secure Messaging is NOT email. Your organization must obtain Direct Secure Messaging credentials that support accredited Health Information Service Provider (HISP) protocols. If necessary, please consult with your organization’s IT department or EMR vendor to determine how to comply with the Final Rule and securely transmit medical records from your EMR to Livanta upon request.

    Where to Submit Medical Records: Medical records may be transmitted to Livanta through Direct Secure Messaging at the following addresses:

    As usual, providers should follow the directions on the specific medical record request they receive from Livanta. The individual medical record request will provide the correct Direct Secure Messaging address to submit each record. Please include the QIO ID in the DSM subject line.

  2. Livanta File Transfer portal: This portal can be easily accessed through Livanta’s website by clicking on the e-LiFT portal button. Before uploading a medical record, providers must enter the QIO ID and a unique identifier supplied on the Medical Record Request. The only accepted file type is PDF.

  3. esMD: esMD can now accept file transfers for Short Stay Reviews and Higher-Weighted DRG reviews. The transmission address to send files via esMD to Livanta is:

    • Short Stay Reviews (SSR)
      urn:oid 2.16.840.1.113883.

    • Higher-Weighted Diagnosis Related Group (HWDRG) Reviews
      urn:oid 2.16.840.1.113883.

    To begin the registration process for esMD, please contact the Centers for Medicare & Medicaid Services at and for more information, visit

Frequently Asked Questions:

Below are frequently asked questions (FAQs) regarding Livanta’s medical record submission requirements. Please check this page frequently for updates and new information.

  1. What are the accepted methods of transmission?

    Answer: Livanta can receive electronic medical records from healthcare providers that have credentials with Direct Secure Messaging (DSM). As an alternative, providers may upload files directly through the electronic Livanta File Transfer (e-LiFT) portal, or use esMD.

  2. What if my organization already has a security feature in our “regular” email systems - can we just email the medical records to Livanta?

    Answer: Livanta will not accept any emailed medical records. Livanta’s DSM system will not accept “regular” emails - messages must originate from your DSM address. Do not send protected health information to Livanta using “regular” email.

  3. Will Livanta continue to fax requests based on the contact information listed in the Memorandum of Agreement?

    Answer: Yes. The faxed medical record request will include an address to securely transmit the record to Livanta in electronic format. As usual, providers should follow the directions on the specific medical record request they receive from Livanta. The individual medical record request will provide the correct Direct Secure Messaging address or other means to submit each record.

  4. Is esMD an acceptable method of transmission?

    Answer: Yes, esMD remains an acceptable method of file transfer.

  5. Will Livanta sign confidentiality agreements or other legal agreements with healthcare providers to use other systems?

    Answer: No, Livanta offers three methods for submitting records in an electronic format which are widely available to healthcare providers and Livanta will not agree to use other systems at this time.

  6. What if my organization does not have an EMR and cannot submit medical records electronically to Livanta?

    Answer: The e-LiFT portal can accept PDF files. Providers with paper medical records can scan these records and save as a PDF file for secure upload through the e-LiFT portal. You can also “print to PDF” on most EMR systems. To speak with Livanta Technical Support for assistance in finding a suitable submission method, please call Livanta’s technical assistance line at 240-712-4300 x 2998.

  7. My IT department says we cannot use e-LiFT or DSM without a security or privacy agreement from Livanta. Will Livanta sign or complete a data security/privacy questionnaire or agreement for my organization?

    Answer: No, the sole agreement permitted between Livanta as a BFCC-QIO and your organization is the required Memorandum of Agreement (MOA). Security and privacy issues are addressed under Section VI. Livanta's systems have undergone the required federal security audits and we have received an authority to operate (ATO) these systems under our CMS contract. This ATO ensures that Livanta’s systems are secure and in conformity with all applicable federal regulations and industry standards.

  1. Is a DSM email address the same as a “regular email address”?

    Answer: Unlike “regular” email, which is routed through an email provider such as Google or Microsoft, a direct email is routed through a Health Internet Service Provider (HISP). Direct email is maintained and governed by a non-profit industry group called DirectTrust.

  2. How does my organization obtain DSM credentials?

    Answer: As necessary, consult with your organization’s Information Technology (IT) department and electronic medical record (EMR) vendor. Typically, setting up this process involves engaging a DSM vendor who will provide you with an application programming interface (API) and DSM credentials. DirectTrust maintains a list of HISP-accredited DSM vendors. Click here to view their website and learn more about DSM vendors.

  3. Can Livanta recommend a DSM vendor?

    Answer: No. Please refer to DirectTrust to learn more about DSM vendors and HISP accreditation.

  4. How much does DSM cost?

    Answer: Please consult with your IT department and EMR vendor.

  5. Can we test our DSM submission process with Livanta?

    Answer: Livanta does not currently have a testing process. The system and new processes were piloted with several providers and were found to be reliable and easy to use.

  6. Does Livanta provide technical support to help providers set up DSM?

    Answer: No. Please consult with your organization’s IT department and EMR vendor.

  7. What if I am having problems submitting a medical record using my DSM credentials?

    Answer: To speak with Livanta Technical Support for assistance in finding a suitable submission method, please call Livanta’s technical assistance line at 240-712-4300 x 2998.

  8. Once we have DSM credentials, can we send general questions to Livanta using Livanta’s DSM addresses?

    Answer: Livanta is prepared to only use DSM for the receipt of electronic medical records.

  9. Is Livanta going to use DSM to notify healthcare providers of a medical record request?

    Answer: Not currently. Until further notice, medical record requests will be issued via fax or mail from Livanta.

  1. What are the requirements for file submission through the e-LiFT portal?

    1. The QIO ID is 13 characters, including dashes. Letters are UPPERCASE.
    2. The EMR Key is six UPPERCASE characters.
    3. The file must end in either .pdf or .xml with a lower-case file name.
    4. The maximum file size is 700 MB.

  2. How do I log into the e-LiFT portal? Do I need a username and password?

    Answer: The e-LiFT portal does not require a log in process. Instead, enter the QIO ID and EMR Key, both of which can be found on Livanta’s Medical Record Request. These identifiers will link your upload document to the appropriate case in Livanta’s review system.

  3. My organization requires that I password-protect or encrypt my files before uploading them to the e-LiFT portal. Is this acceptable?

    Answer: Do not upload documents that have encryption or password protections, as Livanta is not able to access these documents. Using the QIO ID and EMR key will ensure that your file is attached to the correct case. Livanta’s website uses industry standard encryption to ensure the information is encrypted during transmission.

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