ADR Response Support for Hospice Agencies
When a Medicare Additional Documentation Request arrives, the claim waits until the record proves itself. I help hospice teams send a complete, organized response on time, and then close the gaps that drew the request.
An ADR comes with a deadline, and the record has to stand on its own
- 45 daysFor a prepayment ADR from a Medicare Administrative Contractor, your agency generally has 45 calendar days to submit records. If nothing arrives in time, the claim is denied for non response. Medicare Program Integrity Manual, Pub. 100-08, Ch. 3, §3.2.3.2
- Common denialsMany hospice denials come down to a few documentation elements: face to face encounter requirements, the physician narrative statement, timely certification, and a complete election statement. Palmetto GBA hospice prepayment review results
From the ADR letter to the root cause
For hospice, home health, and palliative care agencies that just received an ADR, are seeing more ADRs than they used to, or want an outside review before a request arrives.
Review of the ADR letter
What was requested, the due date, and which claims and benefit periods are affected.
Record review
Each requested claim checked against hospice eligibility and documentation requirements.
ADR risk scoring
A score for each record, so you know where the chart is strong and where the gaps are before you submit.
Packet assembly
Help putting the submission together: cover letter, indexing, and a clear submission order.
Root cause and education
Findings on what put the claims at risk, with focused education for your clinical team.
Ongoing ADR risk audits
Optional scheduled audits for agencies seeing repeat requests.
No surprises, from first call to final report
Conversation
We talk about what is actually keeping you up at night, and I ask the questions a surveyor would.
Written proposal
You receive a proposal with defined deliverables, a timeline, and a fixed fee or retainer before any work begins.
Work and deliverables
I work alongside your team and deliver written findings and next steps your leaders can act on.
- Fixed fee projects: 50 percent deposit, balance on delivery
- Retainers: billed monthly in advance
- Travel: billed at cost
- Proposals: valid for 30 days
Eligibility and Documentation Integrity Review
A record level review of how eligibility is supported across your records, before a contractor asks.
Request a proposal
Tell me what your agency is facing. I will follow up to schedule a conversation and send a written proposal with a defined scope and fee.
