Postpayment Medical Review Results Letter
Upon receipt of Medical Review Additional Development Request (MR ADR) documentation a CGS nurse reviewer will examine the medical records submitted based on the requirements associated with the focus of the review for coverage and payment determination. CGS has 60 days from the date the documentation is received to review the documentation and make a payment determination. Possible outcomes of the MR ADR include affirmation of the original payment in full or denial of the payment (in part or in full). A results letter including allowed or denied claims with estimated overpayment amounts if applicable will be delivered.
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