• Don't waste time and resources sending in extra documentation if you're appealing a claim determination on an additional development request (ADR) from MAC National Government Services (NGS). "Providers are no longer required to send copies of the initial documentation submitted in response to an ... ADR for medical review," NGS says on its Web site. "These initial records become part of the provider's appeal file, which will be available for subsequent levels of appeal." But you should submit any omitted documentation, additional documentation to support the service billed, and supporting statements, NGS recommends. You'll also need the correct appeal form.