Medicare Compliance & Reimbursement

Home health agencies served by HHH Medicare Administrative Contractor (MAC) CGS should be wary of their button choices, a release suggests. Providers commonly choose the wrong method when sending extra documentation for medical reviews.

“Do not use the ‘Submit Inquiry’ button to send medical records in response to our request for additional documentation (ADR)” on the myCGS system, HHH MAC CGS stresses in a message to providers. “You must use the ‘Submit Documents’ button in order for your documentation to correctly index to your pending claim.”

Watch for: “If the time limit to respond to the ADR has passed, the ‘Submit Documents’ button will be grayed,” CGS adds. “Your only option in this case is to request a Redetermination.”

Bottom line: “The ‘Submit Inquiry’ button is available ONLY to ask general questions,” CGS emphasizes.