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What Is An MR ADR?

What Is An MR ADR?

An MR ADR is a Medical Review Additional Documentation Request for claim(s) being processed. Additional documentation is needed that supports the medical necessity of service(s) reported on the claim to ensure compliance with Medicare's coverage, coding, payment and billing policies. The requested documentation must be received within 45 calendar days from the date of the request.

According to the CMS Pub. 100-08, Ch. 3 §3.2.3.2

) claims will be denied if the documentation is not received by day 46. Refer to the Additional Development Request Timeliness Calculator for assistance in determining the date ADR documentation must be received.

For Palmetto GBA's ADR Response Calculator, click here. This will help you submit your documents in a timely manner.

Other Related Websites:

Medical Review Additional Development Request Process

Other links can be found on the Palmetto GBA website; as well as the CGS (A Celerian Group Company) for states other than NC.

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Tags:

Additional Documentation Request, ADR, ADR Tracking, Denial, F2F