ED Coding & Reimbursement Alert - 2015 Issue 6
What To Expect: Understand The 5 ADR Cycles
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Article Overview
This piece outlines how a series of review requests is expected to arrive for MMR-eligible Part B therapy claims and describes the general structure of the five review waves. It is relevant for providers, billing teams, and compliance staff who need to anticipate review timing and volume during a CMS-directed recovery audit process.
Why This Topic Matters
Understanding the review cycle helps organizations prepare documentation workflows and manage workloads during an extended Medicare review period.
What You Will Learn
- How the staged review process is organized
- What the five review phases are intended to cover
- What types of Part B therapy claims are affected
- How review timing is expected to progress over time
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- Compliance professionals
- Therapy providers
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