UNIQUE SITUATION: PCR/ADR

So the person in charged of our PCR thought that a patient was a LUPA and he entered NA when doing the PCR however he made an error and there were actually 5 visits and so an ADR was sent to us. This staff is working on all the documents needed to submit for PCR and we usually have approval for first time submission. My question is: since he made a mistake of putting an NA and if this PCR will be approved or affirmed after submission, do we still have to go through the process of ADR and submit those since the reason we got the ADR is because of the PCR that was marked NA? We are confident that when he will submit the PCR for this patient it will be affirmed. Any input or link you can share will be helpful. Thank you!

Comments

  • edited May 2017

    Unfortunately, there is no adjustment allowed. Once billed no utm there is
    no way to go back. I had a client bill with the UTM in the wrong box even
    though it had been affirmed. He had to go through ADR

    James Plonsey
    President
    Medicare Training & Consulting


  • edited May 2017
    Unfortunately, there is no adjustment allowed. Once billed no utm there is
    no way to go back. I had a client bill with the UTM in the wrong box even
    though it had been affirmed. He had to go through ADR

    James Plonsey
    President
    Medicare Training & Consulting
Sign In or Register to comment.