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QUESTION: ASCA: What kind of supporting documentation should I attach to my Administrative Simplification Compliance Act Waiver Request?


When providers submit an ASCA Waiver, additional documentation should be included. Listed below are examples of supporting documentation that should be sent with the applicable exception.

  • Small Supplier: Payroll records (does not need to include salary information), tax records or a certified letter from a Certified Public Accountant (CPA).
  • Roster Billing: A copy of a roster bill claim.
  • Tertiary Claims: A copy of a tertiary claim.
  • Unusual Circumstance: For software issues, a detailed letter from your software vendor on their letterhead. For billing issues, a letter with a detail description of the billing issue(s).

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Reviewed Date: 12/23/20
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