Q&A: ADR response timelines
Q: Why is it important to respond to additional documentation requests (ADR) in a timely manner?
A: All healthcare organizations are required to respond to ADRs within certain time frames, and failing to do so will only lead to increased scrutiny and more troubles down the line.
[A] common mistake made by auditing teams is not providing a timely response to the contractors’ ADR. Timeliness should be prioritized for all audit responses, especially for pre-payment reviews, as delayed responses could hold up accounts receivable, notes Dawn Crump, MA, SSBB, CHC, vice president of revenue integrity at MRO in Norristown, Pennsylvania.
[Contractors] generally give providers 45 days to submit the requested documentation, but it can vary by auditor and review type (e.g., Unified Program Integrity Contractors have a 30-day deadline). To ensure compliance, auditing staff should verify the allotted time for response upon receiving the request.
They must also keep in mind that the deadline clock starts ticking on the date listed on the ADR notification, not the date the letter arrives at the healthcare facility. While 45 days may seem like a long time period, those days get eaten up very quickly, according to Diane Weiss, CPC, CPB, CCP, CHRI, vice president of revenue integrity and education at RestorixHealth in Metairie, Louisiana.
A lack of timeliness usually occurs when providers submit a paper ADR response instead of a digital file. In these instances, organizations fail to account for mailing and processing delays.
“Providers will typically lose around 10 days of their response window waiting for the letter to arrive at their facility,” says Crump. “Not only that, but it could take even longer for the mail to arrive in your individual department. Also, if you are mailing your response back to the auditor, that shaves off another 10 days.”
Both Crump and Weiss recommend submitting ADR responses electronically. Digital platforms allow for quicker, more convenient submissions and provide organizations with status updates and notifications they would not receive by mail.
Editor’s note: This answer was excerpted from “Governmental audits: Ensuring a thorough, timely reply,” in the October 2025 issue of the NAHRI Journal. The NAHRI Journal is a quarterly journal featuring in-depth analysis and expert advice and is an exclusive benefit of NAHRI membership. Not a member? Join today.