Misrouted Additional Documentation Request Submissions May Result in Processing Delays

Palmetto GBA has recently seen an influx of misrouted Additional Documentation Request (ADRs) and other documentation from providers. Providers are sending documents without coversheets, ADR letters, and/or sending them to the incorrect department. Sending your documentation this way will delay processing.

Before responding to ADRs, please carefully review your letter. Information on how and where to return the requested documentation is contained in your ADR letter.

Return your documents using one of the methods below. Use the coversheet provided. Do not submit by more than one method as a duplicate response will delay the review process.

• Submit your ADR response via esMD (Electronic Submission of Medical Documentation)
• Upload your ADR response via eServices, our free, self-service portal located on the Palmetto GBA website. eServices allows you to upload your ADR response electronically, eliminating the need to fax or mail documents. This is the preferred method.
• To participate, you must have an EDI agreement on file with Medicare. When you upload a document, you will receive a confirmation message when the form is submitted and an additional message containing a Document Control Number (DCN). You can use the DCN to look up form processing status and view your submitted forms.
• Return your documents to the Palmetto GBA medical review mailing address or fax number located in the body of the ADR letter