Ways to Respond to ADRs
When you are ready to submit, refer to the ADR for the specific submission methods available. NGS offers multiple ways for providers to submit their documentation in response to an ADR.
CMS audit contractors notate in their ADR letter how providers can submit the documentation.
- If you have any questions about the ADR received from the CMS contractor, you must contact them directly.
- NGS cannot assist with requests from another contractor.
- Do not submit the documentation to NGS.
NGSConnex Portal
NGSConnex is the preferred platform for submitting documentation with ADRs posted on the day they are issued. Users receive notification in NGSConnex when an ADR is posted. To respond, refer to the “Respond to ADR” or “Respond to ADR Not on List” sections of the Part B NGSConnex User Guide.
Electronic Submission of Medical Documentation
CMS implemented the esMD system to allow Medicare providers to securely submit medical documentation electronically in response to Medicare contractors requests. This reduces provider burden by eliminating paper use and enabling faster receipt of documents compared to traditional USPS mailing.
To use esMD, providers must either develop their own secure gateway or collaborate with a CMS-approved HIH. HIHs are organizations that offer software and secure communication systems to transmit PHI.
esMD is a CMS product. Visit Electronic Submission of Medical Documentation (esMD) for full details and registration instructions.
U.S. Mail, FedEx, UPS
NGS includes a direct mailing address on all ADR letters.
The original ADR must be included in your mailing package along with the requested documentation.
- The original ADR letter has a bar code that NGS uses for scanning purposes.
- Retain a copy of the ADR letter for your records.
- Send only the request documentation and no more; anything received that was not requested will cause processing delays.
Fax
Whan an NGS ADR letter includes a fax number, providers may submit their documentation by fax.
- Verify you have the correct fax number. NGS ADR fax numbers may be similar, if the incorrect fax number is used for the documentation submission, this will delay claim(s) processing.
- Do not respond by fax if a fax number is not included in the ADR letter.
- Claim ADR letters do not contain fax numbers
Paperwork Segment
The PWK segment within the 837 professional and institutional electronic claim transaction allows providers an opportunity to submit documentation when they bill services that may develop for an ADR.
- By filling out the PWK segment, providers notify NGS that supporting documents will follow separately, by mail, fax, or electronically.
- Providers use PWK to submit unsolicited documentation for some unlisted NOC codes and when specific modifiers are included on the claim denoting special circumstances.
Visit Paperwork Segment - PWK or additional information.
Revised 5/27/2025