HOME HEALTH AGENCIES UNDER ADR REVIEW? WE SPECIALIZE IN HH BILLING DEFENSE. CALL TODAY
Priority Service
Home Health ADR Defense — PDGM Billing Specialists Who Fight Back
Your MAC's ADR response window is limited and the stakes are real. Second Sun Billing specializes in home health billing audit defense — protecting your revenue through PDGM-accurate billing, documentation alignment, and structured audit response.
What Is an ADR?
An Additional Documentation Request (ADR) is a formal request from your Medicare Administrative Contractor (MAC) to submit records supporting paid or pending claims. ADRs often signal a broader medical review — if your documentation doesn't align with PDGM grouping or LCD guidelines, you may face repayment demands.
Common HH ADR triggers:
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Homebound status insufficiently documented
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Missing or incomplete physician orders
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OASIS assessment inconsistencies
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PDGM grouping misalignment
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Claim patterns outside MAC benchmarks
Our ADR Defense Services
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ADR Request Review — analyze the ADR, identify claims at issue, assess documentation risk before you respond
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Billing Record Audit — full review of billing record and PDGM grouping accuracy for flagged episodes
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Response Preparation Support — coordinate your response: complete, accurate, on time
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Overpayment Strategy — repayment, installment plan, or appeal? We assess your options
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Ongoing Billing Correction — fix the upstream patterns that triggered the ADR
Clinical Documentation — Referred to Second Sun Services
Winning an ADR appeal requires that your clinical documentation supports medical necessity. For clinical documentation audits, LCD alignment, F2F review, and appeal writing, we refer clients to our sister practice:
Second Sun Services — Hospice & Home Health Clinical Documentation Consulting