Non-Medical Record Review

7.2.2.2 - Non-Medical Record Review (Rev. 721; Issued: 06-09-17; Effective: 07-11-17; Implementation: 07-11-17) Non-medical record reviews uses manual intervention, but only to the extent a reviewer can make a determination based on information on a claim. It does not require clinical judgment in review of medical record documentation. Contractors shall only perform a non-medical record review for denials of related claims and/or no receipt of ADR documentation where such denials cannot be automated.