Honor timelines. Set up a tickler file to ensure records are sent within the 45 day time period allotted. Assign a staff member to take ownership for this process and if you have problems with it currently, set up a log to help identify the root of
the problem.
Do not submit documentation until requested by an ADR( Additional Documentation Request).
Send what is requested and any other documentation that supports the service(s) in question.
Develop a QA process whereby someone looks at what is being sent before it leaves your office. This will ensure that the correct information for the date of service being requested is actually being sent.
Make sure documentation is legible, dated, signed, and the beneficiary identification is present and correct.
For time based codes, ensure the times are documented and reported the same on all related documentation.
Return the documentation in the color coded envelope provided. If this envelope is too small for what is being sent, use the mailer of your choice and affix the color coded envelope to the package as an address label.
If your mail is opened in a central location, be sure the mailroom does not dispose of the color coded envelopes.
If you are requesting a redetermination or an appeal, be sure to include a written request for redetermination as Medicare cannot accept an implied request for review. Also, check the Providers’ Newsletter or your State Medicare website to be certain
you are mailing to the correct address.
Please review your internal mail procedures to ensure there is no delay on time sensitive documents.
