Free tool · Medicare ADR
Medicare ADR deadline calculator
Enter the date on your Medicare additional documentation request. See the last day your records can be received, the day the claim denies automatically, and a safe target date to send your response.
Skilled nursing facilities have 45 days. Records must be received by the Medicare contractor, not just sent, by day 45.
Add this only if a claim was already denied and you are considering an appeal.
Enter a date to see your deadlines.
How it works
Day 45 is a receipt deadline
Medicare contractors give skilled nursing facilities 45 days from the request to provide documentation. If nothing is received by then, the claim is denied automatically on day 46. We suggest a target send date of day 30, which leaves time to fix gaps and confirm receipt. That target is our recommendation, not a Medicare rule.
If a claim is denied
The first level of appeal, a redetermination, is generally requested within 120 days of receiving the denial notice. Check your notice for the exact instructions.
Related
Questions
ADR deadline questions
How long does a skilled nursing facility have to respond to a Medicare ADR?
45 days. If the Medicare contractor has not received the records by then, the claim is denied automatically on day 46.
Does day 45 mean the day we mail the records?
No. Day 45 is the last day for the records to be received by the contractor, so send early and confirm receipt.
How long do we have to appeal a denied claim?
A redetermination, the first level of appeal, is generally requested within 120 days of receiving the denial notice.
Need help now?
Working on an ADR response right now?
Call and we will review the request with you the same day.