Docs / Working cases

Responding to an ADR

An ADR means a Medicare reviewer wants the records behind a claim before paying. Deadlines are strict — typically 45 days from the letter, and no response means automatic denial. (For the Medicare-side mechanics, see the ADR guide.)

Recording the ADR

On the case: Record ADR received. Capture the letter’s date and what’s being requested; the case enters ADR-pending status and joins the reminder system’s watch list so the deadline can’t quietly slip.

Drafting the response

Draft response (Professional plan and above) has the AI read the ADR’s requests against everything already on the case and produce:

• Document recommendations — which of your case documents answer which request
• An editable cover letter — mapping each requested item to its enclosed document, ready for your edits before anything goes out

Nothing sends automatically: you review the draft, adjust the enclosure list, and edit the letter freely.

Assembling and sending

The response packet builds from the documents you selected — cover letter first, then the enclosures — and downloads as one PDF for submission per the letter’s instructions (esMD, fax, or mail). Record the response date on the case for the audit trail.