Respond to ADRs within 45 Days

Respond to ADRs within 45 Days

If you submit claims to Medicare, know that you have 45 days to respond to an Additional Documentation Request (ADR) that you receive from a Medicare administrative contractor (MACs) or Zone Program integrity contractor (ZPIC). According to MLN Matters®MM8583, “Failure to respond within 45 days of a prepayment review ADR will result in denial of the claim(s) related to the ADR. Make sure your billing staffs are aware of these changes.”

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Michelle Dick
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Michelle Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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About Has 136 Posts

Michelle A. Dick has been executive editor for AAPC for over seven years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. Dick has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

One Response to “Respond to ADRs within 45 Days”

  1. Michelle G. says:

    You actually have 30 days.

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