Last Modified: 11/11/2020
Location: FL, PR, USVI
Business: Part A, Part B
Q. How do providers prepare documentation for submission?
A. The ADR/record request letter includes information to help prepare documentation for submission to Medical Affairs.
Once the request is received, do the following:
• Collect all requested documentation
• Verify all documentation requested is included in your submission
• Attach the individual fax coversheet as the coversheet to the applicable records
If you are responding to multiple claim requests, clearly separate the documentation for each claim by inserting the first page for each individual fax coversheet separately for the applicable documentation pertaining to the claim selected. Multiple responses sent together, but not separated, may result in documentation being imaged as one claim or may be rejected completely.
We have additional resources available on our website to assist with response. Click the Medical Review tab on the navigation menu located on the left side of your screen. Select "Other Medical Review Activities.” Then select "Service-Specific Review." Documentation checklists and additional education resources are included under the procedure codes/topics under service-specific review.
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.