ADR Associated Costs
SMRC is not allowed to reimburse providers for costs related to submission, copying or mailing of documentation.
When a provider/supplier receives an Additional Documentation Request (ADR) letter from Noridian, they are required to provide medical records and supporting documentation needed to review the referenced Medicare claims. Such a request complies with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, which allows release of information for treatment, payment, and healthcare operations.
ADRs are mailed to the address a provider/supplier has on registry with CMS.
How to Respond to an ADR – Learn about the ADR process and how to submit requested documentation
Medical Documentation Signature Requirements – View signature requirement details
Provider Compliance Group (PCG) Medical Review Process Flowchart – View a flowchart outlining the PCG Medical Review Process
- Additional Documentation Request (ADR)
- CMS Internet Only Manual (IOM), Publication 100-08, Medicare Program Integrity Manual
- CMS Medicare Coverage Database (MCD)
- CMS MCD Archive
- 42 USC 1320(c) (5) (A) (3) and 1833 of the Social Security Act
Last Updated Apr 25, 2023