If a supplier is dissatisfied with a Redetermination, the next level of appeal is called a Reconsideration. Suppliers must file the Reconsideration request within 180 days of the date of the Redetermination decision.
A Reconsideration may be requested and submitted to the Qualified Independent Contractor (QIC), C2C Innovative Solutions, Inc., in writing using one of two ways:
- Complete and submit the Reconsideration Form [PDF]
- Submit a written request containing at least the following information:
- Beneficiary name
- Beneficiary Health Insurance Claim Number (HICN)
- Specific service(s) and item(s) for which Reconsideration is requested and specific date(s) of service
- Name and signature of party or representative of party
- Name of contractor that made the Redetermination
To check the status of a reconsideration request go to the "Providers: Appeal Status Information " section of the Q2 Administrators web site.
Last Updated Nov 03, 2016