ADRs: How to Respond & Maneuver Through the Medical Review & Appeal Process

Postpayment ADRs are increasingly occurring nationally in home health and hospice. As we transition from a public health emergency (PHE), we are moving into a period of escalated medical audit reviews. With additional document requests (ADRs), it is more likely than not that your agency will receive one. Take a deep dive into the medical audit review process and best practices, including recommended documentation, the submission process, and critical timelines. This informative session will review cover letters, how to highlight your case for care, and where to focus the auditor’s attention. It will examine the appeal process, when to use outside resources, and ways to increase favorable outcomes.

This timely session is recommended for board members, administrators, finance staff, executive leadership, clinical managers and supervisors, QAPI personnel, medical directors, liaisons, field staff, and intake and admission team members.