If my claim is denied for failure to submit requested documentation within 45 days of an Additional Documentation Request (ADR), should I submit a new claim and attach the requested documentation with the new claim?

Answer: 
No, do not submit a new claim. If your claim was denied with remittance advice remark code RARC M127 because the information requested by Medical Review was not returned within 45 days of the ADR letter date, return your ADR response(s) as soon as possible within 120 days from the date of the receipt of the denial. Submit your documentation with a Medical Review ADR Response — Late Submission Form. If we receive your response more than 120 days from the receipt of the M127 denial, Medical Review will not review the documentation. The documentation will be handled as a redetermination by Appeals. The receipt of the notice of the denial is presumed to be received five days from the date of the remittance advice.

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Provider Contact Center: 888-355-9165

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