Last Modified: 10/4/2022
Location: FL, PR, USVI
Business: Part A, Part B
Q: How do providers prepare documentation for submission?
The Initial Notification Letter includes a documentation checklist to help providers prepare documentation for submission. The documentation checklist can also be found under targeted probe and educate review topics
Once an ADR is received, a provider should do the following:
• Collect all requested documentation
• Verify all documentation requested is included in your submission
• For prepay reviews, attach the first page of the original ADR request letter as the coversheet to the records, for post-pay reviews individual fax coversheets are provided for use.
If you are responding to multiple MR ADR requests, clearly separate the documentation for each claim by inserting the first page for each ADR letter separately for the applicable documentation that pertains to that ADR letter/individual fax coversheet. Multiple responses sent together, but not separated, may result in the documentation being imaged as one claim or claim may be rejected completely.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.