New Process for Handling esMD
When submitting requested medical documentation to payers, time is of the essence. In the age of electronic submission of medical documentation (esMD), “It’s in the mail” is an antiquated and ineffective excuse. Missing a deadline could mean lost revenue for your medical practice.
The Centers for Medicare & Medicaid Services (CMS) instructs review contractors in Transmittal 426 on the process for handling late esMD.
When a provider has failed to submit a response to an Additional Documentation Request (ADR) letter by the deadline, CMS says, Medicare administrative contractors (MACs) should use the esMD content transport services (CTS) receipt date as the date the documentation was received. If the CTS receipt date is outside of the contractor’s normal business hours, the following business day may be used as the receipt date.
The moral of this story: If you have 30 days to respond to an ADR letter, don’t wait until day 29.