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Last Modified: 10/4/2022 Location: FL, PR, USVI Business: Part A, Part B

How do providers prepare documentation for submission?

Q: How do providers prepare documentation for submission?
A: 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.
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