tci Medicare Compliance & Reimbursement - 2015 Issue 6

What To Expect: Understand The 5 ADR Cycles

Get ready for a series of requests that will span all of your MMR-eligible claims. Brace yourself for an ongoing barrage of additional development requests (ADRs). In resuming the Manual Medical Review (MMR) program for Part B therapy claims, the Centers for Medicare & Medicaid Services (CMS) has instructed recovery audit contractors (RACs) to conduct reviews in a series of “waves.” RACs will conduct MMRs in five waves to address all 2014 reviews, said Springfield, MO-based Suzy Harvey, managing healthcare consultant for BKD CPAs & Advisors, in a recent analysis. If you have therapy MMR-eligible claims, you...

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