ADRs: How to Respond & Maneuver Through the Medical Review & Appeal Process
Date/Time: 06/01/2022, 12:00 pm - 3:00 pm
Medical audit reviews are on the rise! Don’t be caught off guard.
Ensure your agency understands the ADR and review process. Submitting correct documentation, following the timeline, and putting best practices to work increase the odds of a favorable outcome.
AFTER THIS WEBINAR YOU’LL BE ABLE TO:
- Differentiate between types of government audits
- Define the ADR process, including agency responsibilities and critical timelines for submission
- Identify the documents and benefit periods to include with a medical review audit submission
- Explain the purpose of a cover letter for each patient medical audit review submission
Postpayment ADRs are increasingly occurring nationally in home health and hospice. As we transition from a public health emergency (PHE), we are moving into a period of escalated medical audit reviews. With additional document requests (ADRs), it is more likely than not that your agency will receive one. Take a deep dive into the medical audit review process and best practices, including recommended documentation, the submission process, and critical timelines. This informative session will review cover letters, how to highlight your case for care, and where to focus the auditor’s attention. It will examine the appeal process, when to use outside resources, and ways to increase favorable outcomes.
WHO SHOULD ATTEND?
This timely session is recommended for board members, administrators, finance staff, executive leadership, clinical managers and supervisors, QAPI personnel, medical directors, liaisons, field staff, and intake and admission team members.
- NGS: Hospice Documentation Checklist
- ADR patient cover letter sample
- Additional links to:
- Prepayment Medical Review Additional Document Request (MR ADR)
- Medical Review Additional Development Request (MR ADR)
- Postpayment Medical Review Additional Development Request (MR ADR) Quick Resource Tool
- Hospice Documentation Checklist Tool
- Sample ADR postpayment notification letter
- Training log
- PDF of slides and speaker’s contact info for follow-up questions
AHEARN ADVISEMENT PARTNERS