CMS+MAC+Medical+Review+Requests+for+Medical+Records

When an Additional Development Request (ADR) is sent to a provider, the provider has 30 days in which to return the medical records to NHIC, Corp. The claim will deny if the records are not received by day 45. Denial code 56900 is appended to these claims indicating the denial occurred for lack of response to the ADR. Providers should aim to return their records in response to an ADR by day 30 in order to avoid denials for timeliness. When an ADR is generated, the claim will be found in status/location S B6001. After the records are received by NHIC, Corp., the claim will be moved into Status/location S M5REC. The claim will remain in this location until it is reviewed and processed. Upon receipt, the medical records are scanned. When submitting hardcopy medical records, please consider the following suggestions:
 * Medical Review Requests for Medical Records **
 * Please do not use staples or paperclips
 * Each packet should be bound with a rubber band with the appropriate ADR on top and the correct medical records
 * Please avoid mixing single and double-sided documents
 * Return the medical record to the correct address listed on the ADR
 * Please do not include any other correspondence or claims that do not pertain to your ADR
 * Please do not send medical records until you receive an ADR

NHIC , Corp. accepts electronic medical records submitted by an appropriate Health Information Handler. More information on this can be found in the Electronic Submission of Medical Documentation (esMD) Pilot Project article available on the NHIC, Corp. Web site at http://www.medicarenhic.com/Part __A__ <span style="color: #000000; font-family: 'Verdana','sans-serif'; font-size: 13.3333px;">(Education > Education Articles > 26 January 2012). <span style="color: #000000; font-family: 'Verdana','sans-serif'; font-size: 13.3333px;">Additional information on the ADR process can be found in the Additional Development Request billing guide available on the NHIC, Corp. Web site at <span style="color: #0000ff; font-family: 'Verdana','sans-serif'; font-size: 13.3333px;">http://www.medicarenhic.com/Part A <span style="color: #000000; font-family: 'Verdana','sans-serif'; font-size: 13.3333px;"> (Billing Support > Billing Guides).