Additional Document Request Workshop

Home Health and Hospice Tracks


The workshop will begin with a general overview of Additional Document Requests (ADRs) by expert faculty Annette Lee, who worked for over a decade with a MAC in medical review and education. This session will review the different types of audits and the processes followed by Medical Review, CERT, and RACs. Attendees will gain a better understanding of the medical review process, Medicare’s Additional Development Request, and Progressive Correction Action processes. Additionally, Ms. Lee will discuss the appeals process and documentation that would support the medical necessity for both home health and hospice.

This Home Health breakout session features NGS Home Health Clinical Consultant, Lauri Domingo RN, who will be reviewing tips on responding to an ADR, the top medical review denials, and tips on avoiding those denials. This session will also cover Documentation of all five eligibility requirements to include the Face-to-Face Encounter, the Plan of Care, Homebound Status and the Need for Skilled Services.

  • Identify top denial reasons for Home Health Medicare claims
  • Develop an understanding of how physician documentation supports patient eligibility for Medicare Home Health Services
  • Overview of all five certification requirements
  • Up to date references and resources for 2018 Medicare Home Health Regulations
  • Discuss the Targeted Probe and Educate Medical Review Activities

With increasing regulatory requirements and scrutiny of documentation to ensure services billed to Medicare are reasonably and medically necessary and meet the statutory requirements itís imperative that providers understand the requirements and the documentation required to support Medicare coverage.

This Hospice breakout session features National Government Services Provider Outreach and Education Consultant, Corrinne Ball who will be discussing the Targeted Probe and Educate process, responding to a hospice ADR, and documentation requirements. During this session we will examine the targeted probe and educate (TPE) process, data that drives medical review audits and top medical review denials. This session is designed to give providers the tools, and information to design and implement a strategy to be successful during a medical review audit.

  • Gain an understanding of the targeted probe and educate (TPE) process
  • Identify top denial reasons for medically reviewed Hospice Medicare claims
  • Develop an understanding of how documentation plays a key role in supporting terminal prognosis
  • Gain an understanding of the documentation requirements to support services billed for Hospice


icon icon

ADR Response Guide for
Home Health Organizations

ADR Response Guide for
Hospice Organizations

This guide is designed to assist your organization in preparing for and responding to CMS Additional Development Requests (ADRs). The guide discusses all aspects of the ADR process that your organization can incorporate into your organizational processes. Includes: ADR tracking logs, staff roles in the ADR process, compiling of the ADR packet, audit tools and the necessity of staff education. Produced by The Corridor Group.

Save $20 on this resouce by ordering your copy when you register for this ADR Workshop! To order resources at reduced pricing please order via phone at (916) 641-5795 x 113 or fax registration form to (916) 641-5881.


Annette Lee
RN, MS, COS-C, Cahaba GBA, CGS

Provider Insights, Inc.

Ms. Lee has been an RN for 20 years, with 12 years of experience in home health management and patient care service delivery. Over the last 10 years she has provided review and education at the Regional Home Health and Hospice Intermediary (RHHI) level for home health and hospice providers. Annette has a wide array of experience that makes her accessible and a valuable resource to providers. Her career has had an emphasis in community health care, with positions ranging from a community case manager to The Provider Outreach and Education Coordinator at Cahaba GBA. These experiences have made Annette an expert in both the clinical and quality medical review sides of coverage for home health and hospice. Annette is the founder of Provider Insights, Inc.

Corrinne R. Ball

Provider Outreach and Education Consultant
National Government Services

Lauri Domingo

Home Health Clinical Consultant
National Government Services


Cancellations are subject to 20% handling fee. There will be NO REFUNDS issued for cancellations received within 10 business days prior to program. Cancellations must be in writing. Refunds will not be made for no-shows. However, substitutions will be allowed. Should CAHSAH® cancel the program, a full registration fee refund will be issued.


Provider approved by the California Board of Registered Nursing (Provider #CEP2463) for up to five and one half (5.5) contact hours of continuing education. You must be present for the entire workshop to earn Continuing Education Units. No partial credits can be given. Certificates are distributed at the close of the program.