ECR stands for Electronic Cost Report.  CMS requires most of the Medicare cost reports to be submitted in an electronic file format rather than on paper.  CMS approved software must be used to generate the ECR.  The software actually produces two files; 1) the ECR file and 2) the PI (Print Image) file.  Both of these files must be transmitted in an electronic format , typically by burning onto a CD, and submitted to the Fiscal Intermediary, together with a printed and signed Signature Page.

The ECR is in a text format, and each field will have input for a given cell of the cost report and its location (Worksheet, line, and column). The ECR file has a three line encryption of a little over 70 characters at the end of the electronic file which gets printed to the Medicare cost report signature page.