Acceptable Submission Methods for Responses to ADRs

3.2.3.5 - Acceptable Submission Methods for Responses to ADRs (Rev. 13821; Issued:06-09-26; Effective: 02-26-26; Implementation: 02-26-26) This section applies to MACs, RACs, CERT, SMRC, UPICs, and I- MEDIC, as indicated. Reviewers shall be clear in their ADR letters about what documentation submission methods they will accept from a provider or Health Information Handler (HIH). The MACs, CERT, SMRC and RACs shall accept documents via paper, fax, CD/DVD, electronic submission of medical documentation (esMD), and contractor website portal. A. Paper The MACs, CERT, SMRC, and RACs are encouraged to state in the ADRs that paper medical documentation can be mailed by any means including US Postal Service, FedEx, UPS, or certified mail. To facilitate delivery of documentation, MACs, CERT, SMRC, and RACs should provide a physical mailing address instead of a P.O. Box. B. Fax If the MACs, CERT, SMRC, or RACs have the capability to offer fax confirmation, they are encouraged to send such confirmations with every successfully received fax. C. Imaged Medical Documentation File(s) Sent on CD/DVD The MACs, CERT and SMRC shall state in the ADR that imaged medical documentation files on CD/DVD may be mailed by any means. RAC ADRs shall provide a website link or phone number that provides information regarding the requirements for submitting imaged documentation on CD or DVD. D. Medical Documentation Sent via Electronic Submission of Medical Documentation (esMD) Transmission Electronic Submission of Medical Documentation (esMD) is a system that allows providers/HIHs to submit medical documentation over secure electronic means. Information about the esMD system can be found at www.cms.gov/esMD. MACs, SMRC, and CERT are encouraged to state in their ADRs how providers can get more information about submitting medical documentation via the esMD mechanism. Any time a new esMD service or document type is being offered, and any contractor wants to publish a public announcement (website, list serve, tweet, etc.) the contractor must clear the announcement with CMS E. Contractor Website Portal The MACs are encouraged to state in the ADRs that medical documentation can be submitted by this route. F. Kiteworks The UPICs and I-MEDIC may accept medical documentation submitted via this route.