Additional Development Request (ADR)- Medicare and Targeted Probe and Educate Audits Help
Have you received an Additional Development Request from Medicare? If so, we can help. Our Medicare experts will submit Additional Development Requests (ADRs) on your behalf of your agency, giving you the peace of mind that they’re done correctly.
Additional Development Requests and How to Respond
With any ADR request, you should respond to the audit promptly and accurately. Failing to do so will cause a claim denial, and the consequences can be rather expensive. In fact, your agency could be in danger of losing your license if you do not properly respond with an appeal.
Home Health Audits
Reimbursements for hospice and home health care have undergone drastic changes. The Centers for Medicare and Medicaid Services recently announced that targeted Probe and Educate audits would be mandatory. CERTs, (Comprehensive Error Rate Testing), were also included in this announcement. Unfortunately, several home health and hospice centers have felt the effects.
Fortunately, our team has a lot of experience with these audits. Our experts can help almost any hospice or home health care agency with the ADR appeals process.
Ways We Can Help
We have a plethora of experienced specialists such as registered nurses, certified legal nurse consultants, billing specialists, coders, certified professional accountants, and attorneys who will provide effective Medicare ADR assistance.
Our specialists will work with you to cover 5 levels of the appeal process:
- MACs, (Medicare Administrative Contractors)
- RACs, (Recovery Audit Contractors)
- ZPICs, (Zone Program Integrity Contractors)
- CERTs, (Comprehensive Error Rate Testing)
- Probe and Educate
We can help you identify the correct documentation you will need to properly respond to your audit. Our nurses have over 20 years of experience in clarifying which information is essential for ADR appeals. They will also help you prevent unnecessary ADRs in the future by providing recommendations and expert feedback. Doing this will prevent any further lack in compliance or medical records reporting.
Improve Your Operational Performance
Our ADR professionals will work with your team to locate potential problems and instruct your agency on best practices. They will help you develop protocols that will prepare you for future challenges in the industry.
We provide you with personalized Medicare ADR assistance. We will focus on the comprehensive data required to prepare the correct documentation in the time frame stated. Our goal is to help you get every penny you are owed by Medicare. We also help you prevent unwarranted medical record audits in the future.
We understand the challenges you face every single day as a Home Health or Hospice Agency. If you’ve received an Additional Development Request from Medicare, you don’t have to face it alone. We can help you get the reimbursement you deserve. Call us today.
For more information about our ADR services, please call us at 855-500-ADRS.