Additional Documentation Request (ADR)

We Think Like Auditors, So You Don’t Have To

We handle hospice ADRs with auditor-level precision—so you get paid without the stress.

350+

1,000+

Charts Reviewed & Paid Back

Happy clients

CMS Audits Types

Medicare Administrative Contractors (MAC)

Supplemental Medical Review Contractor (SMRC)

Recovery Audit Program (RAC)

Office of Inspector General (OIG)

Quality Improvement Organization (QIO)

Unified Program Integrity Contractors (UPIC)

ADR Support Services We Provide

• Initial & Appeal-Level ADR Submissions
  Complete preparation and submission of all required documents for initial or appeal-level ADRs.

• Clinical Record Review & Audit
  In-depth audit of medical records with a focus on Medicare and payor-specific coverage, billing, and coding compliance.

• Summary Letter & Clinical Report Development
  We craft professionally written cover letters and clinical summaries to accompany your ADR submissions, tailored to highlight compliance and support claim validity.

• Documentation Gap Identification & Recommendations
  Identification of potential documentation weaknesses that may trigger denials, with step-by-step recommendations to resolve them.

• Consultation on Supporting Documentation
  Guidance on compiling and organizing documentation such as:

  • Progress notes and physician evaluations

  • Imaging, laboratory, and pathology reports

  • Hospital, nursing home, and home health records

  • Physician orders and certificates of medical necessity

  • Supplier/lab/ambulance service records

• Assistance with Other Medicare Contractor Audits
  Expert support for additional audits including:

  • TPE Reviews (Targeted Probe and Educate)

  • RAC (Recovery Audit Contractor) Audits

  • UPIC (Unified Program Integrity Contractor)

  • CERT (Comprehensive Error Rate Testing)

  • ZPIC/SMRC/OIG Reviews

• Timely Submission Management
  Ensuring that all responses are organized and submitted within the required timeframes to avoid payment delays or denials.

• Staff Education & Prevention Strategies
  Training your staff on documentation practices to reduce the likelihood of future ADRs and audits.

"Responding to a hospice ADR yourself can lead to costly mistakes, as the process requires a deep understanding of Medicare and insurance compliance rules. Incorrect or incomplete documentation can result in payment denials, delayed reimbursements, or even audits. Without expert knowledge, you may miss critical details or fail to present your case effectively, causing unnecessary stress and financial strain. Hiring an expert ensures a thorough, accurate response that minimizes risks and helps secure the appropriate payments for your services."

- Senior Director of Consulting Services at HealthBridge

Contact us for a Free Consultation

HealthBridge has extensive experience in ADRs with Medicare, Medi-Cal, Medicaid, and other private insurance companies. Our team is composed of former healthcare auditors who know exactly what to look for. Contact us today for a free evaluation of your case.