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Responding to a Hospice Additional Documentation Request (ADR) This is provided as a reminder of what to include when responding to an ADR. Valid, signed notice of election. Name of hospice providing care. Understanding that the other Part A benefits for the terminal illness are waived.
An Additional Documentation Request (ADR) is typically a result of a payer's probe or edit, which may be specific to a provider, a service, a payment threshold, a Current Procedural Terminology (CPT) code, or International Classification of Disease, 9th Edition code (ICD-9).
General Information. In certain circumstances, National Government Services or other contractors working under the CMS may need to request additional information with regard to claims submitted to the Medicare Program. The requests for additional information letters are called ADRs .
If you are missing the ADR letter and cannot provide it as the cover sheet, please clearly indicate "ADR Response" and include the following critical information on your cover sheet: Medicare Number, claim number, and dates of service on the claim.
What is the Full Meaning of ADR? An Additional Development Request (ADR) occurs when the payer of a submitted insurance claim requests that the home health agency (HHA) provide supporting documentation to justify payment for a specific period of service.
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An Additional Development Request (ADR), also known as an Additional Document Request, is issued for the purpose of reviewing documentation for specific issues as determined by the Centers for Medicare and Medicaid Services (CMS) or other governing agencies of the federal government.
General Information. In certain circumstances, National Government Services or other contractors working under the CMS may need to request additional information with regard to claims submitted to the Medicare Program. The requests for additional information letters are called ADRs .
The Centers for Medicare & Medicaid Services (CMS) has modified the additional documentation request (ADR) limits for the Recovery Auditor program for providers.
\u2013 When a claim is selected for medical review, a medical review additional documentation request (MR ADR) is generated requesting medical documentation be submitted to ensure payment is appropriate. Documentation must be received by CGS within 45 calendar days for review and payment determination.
Medicare Administrative Contractors (MACs) request medical documentation from the billing provider when the MAC needs more information to make an initial claim determination. The billing provider is responsible for returning the documentation to the MAC within 45 days of the ADR letter date.

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