- Medical Review Portal in NGSConnex
- Best Practices for a Successful Targeted Probe and Educate Review
- Medical Documentation Signature Requirements
- Address Corrections for Providers
- Additional Developmental Request Letters Overview
- How to Find and Respond to TPE ADR
- Methods for Submitting an ADR
- Sample TPE Notification Letter
- Sample TPE Notification Letter
- Results Letters
- Appeals
Additional Development Request Letters Overview
National Government Services may require additional information in order to appropriately process claims submitted to the Medicare Program. These requests for additional information letters are called ADRs. When a claim is selected for review, an ADR is generated requesting medical documentation. To ensure proper payment is made for submitted charges, providers and facilities should have processes in place to ensure that the appropriate staff is receiving and responding to ADRs in a timely fashion to avoid denials due to non-response. Providers must respond to ADRs thoroughly and promptly to prevent processing claim delays and potential denials. NGS recommends responding to ADRs within 35-40 days of letter date. To calculate the response time for you ADR letter, visit our Additional Development/Documentation Request Timeline Calculator.
How Will I Receive My ADR Letter?
- ADR letters are mailed to either the “Pay To” or “Practice Location” address that the provider has designated on their enrollment application to National Government Services.
- Visit the Address Corrections for Providers section of the TPE Manual for more information.
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Revised 6/6/2023