Home Health & Hospice Week

Industry Note:

Avoid ADR Pitfalls With These MAC Tips

You can increase your chances of successfully defending your claims against additional development requests if you follow some simple rules about how to submit your ADR response.

Tip #1: Don't use staples or paper clips in your records, instructs HHH MAC NHIC in a message to providers. Instead, use a rubber band to bind each ADR (on top) with its pertinent medical records.

Tip #2: Avoid mixing single- and double-sided documents.

Remember that your ADR'd claim will receive denial code 56900 if NHIC doesn't receive records by day 45, the MAC says.

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