CMS encourages batch attestation, but does not provide very much support
When we built the Batch Attestation add-on to our Meaningful Use system, we expected a lot of assistance from CMS. After all, they published it in the Federal Register, dedicated a page on their website to specifications and user manuals, and stated that it was expected to dramatically improve reporting burden.
At least, so you might think.
Truth is, there is not even a test site. Once you have built an initial file, you have to submit live EP data into the CMS production system to conduct your tests!
Now, we think we are pretty good system developers and testers. But what we found was that the specifications were sometimes inconsistent, and sometimes unclear. And there were a number of undocumented "requirements" that only pop up when you submit. In spite of our diligence in reading everything multiple times, doing good design, and a lot of "dry run" testing where we would manually review the interface files ... in spite of all that, we ended up with over 20 submissions before the file was correct!
Take, for instance, the requirement for gathering Vital Signs. There is not an explicit specification on this topic, nor a clear flow of what CMS expects. What we found, was that a provider file needed to contain three distinct line items for Vital Signs, even though it is only one measure. Each line item had to be in the correct sequence, too. The key was ultimately the definition of exclusions. Even in the case of providers claiming no exclusions, and fulfilling only the "standard" requirement of height, weight and blood pressure, the input file needed to contain each of the "non-standard" options, with a statement that they were not being applied.
Working our way through was almost entirely on our own as well. There is a help line (not dedicated to Batch Attestation, but the overall EHR Incentive Program Help line. When encountering a production error not covered by the specification, we were required to log a call. On this system you don't receive call-backs, but you must call in periodically to check your ticket number for a response.
Here is a good bit of advice, though. Eventually you will probably get to talk to the Batch Attestation Specialist (at the time we did ours, there was only one!). Once you have that person, if you keep their name you will probably be able to dial through directly to them. Save that name!!!
Of course, the best option is Meaningful Use Monitor - the middleware between EHR, Quality Reporting - and CMS! And be sure to download the Meaningful Use Manifesto for a summary of Best Practices around the job of administering and defending Meaningful Use.