TPE Manual

How to Find and Respond to TPE ADR

Once you receive notification your facility is being placed on medical review, you’ll receive instructions on how to find the ADR. The ADR is a request to submit documentation for review to ensure proper payment is made. The ADR will have the documentation which should be included for a particular service date.

Part A Providers Only: Steps to View and Print ADRs from FISS/DDE Provider Online System

  1. Access the claims through the Claims Inquiry screen/option.
  2. Type 01 at the FISS/DDE Online System Main Menu and then type 12 on the Inquiry Menu for claims.
  3. At the Claims Inquiry screen, type SB6001 in the S/LOC field and press <Enter> all claims in the SB6001 status and location will be displayed (SB6001 status indicates that an ADR has been generated for a claim).
  4. At the desired claim, type S to the left of the claim under the SEL field and press <Enter>.
  5. The ADR letter follows claim page 06 of the claim.

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Reviewed 11/25/2024