Medical Review sends Additional Development Request (ADR) letters to request medical records for review. At times, the provider address is no longer current and the ADR letters are returned as undeliverable.
Address changes and provider file updates must be reported via the Internet-based Provider Enrollment Chain and Ownership System (PECOS). The preferred method for submitting initial applications or making address changes to your provider file is through Internet-based PECOS.
You may also print the electronic versions of the Medicare Enrollment Application CMS-855A form from the Centers for Medicare & Medicaid (CMS) website.
There are two address areas on the CMS-855A form; Master and Other. The ADR is automatically generated from the Other Address in FISS. Please ensure the Other Address reflects the address where ADRs should be mailed. Make sure all required fields are completed and the appropriate signature is submitted.
For instructions on changing your address, please visit the Tutorial: Change of Practice Address for Part A Providers (Using CMS-855A) available on our website.