Last Modified: 4/17/2021
Location: FL, PR, USVI
Business: Part A, Part B
Q. May I submit medical documentation in response to an additional documentation request letter (ADR) letter via fax?
Use the following fax coversheets to submit the documentation for prepay claims ADRs:
The fax numbers to use are provided on the appropriate form. Be sure to select the correct form and fax number based on your line of business (Part A or Part B) and your location (Florida, Puerto Rico, or the U.S. Virgin Islands).
For reference, the forms are also located on the Medical Documentation page
under "Additional documentation request (ADR) fax coversheet."
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.