Supporting Documentation

When Asuris requests supporting documentation, it is either indicated by a message code on the payment voucher or by letter. The Asuris Clinical Edits by Code list contains the supporting documentation requirements for most services and supplies, listed by Current Procedural Terminology (CPT^®) and Healthcare Common Procedure Coding System (HCPCS) code.

To submit documentation for electronic or paper claims, please use the Supporting Documentation Cover Sheet (PDF). This is a standard cover sheet for submitting information in support of a claim. Using this cover sheet will ensure that documentation is “attached” to the right claim(s) and will expedite processing. Please complete all fields on the form and:

• Include the claim number.
• Include the office contact information.
• Complete all subscriber and patient information.
• Do not use for corrected billings or billing disputes.
• Indicate if claim was submitted electronically if applicable.
• In the comment section indicate what type of documentation is attached.
• Mail the completed form with the additional documentation to the address indicated in the letter. If not indicated, mail to the correspondence address.

Note: To print a PDF document, you need Adobe^® Reader^®. Download it now for free.