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 Noridian 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.
Formal Telephone Discussion Demonstration
C2C Innovative Solutions, the QIC contractor, is conducting a Formal Telephone Discussion Demonstration for DME MAC Jurisdictions C and D. Suppliers can provide verbal testimony and submit any additional documentation that would assist in a possible favorable determination. The demonstration will be conducted with a reconsideration professional in a formal, recorded telephone discussion. This discussion will be included, and considered as part of the appeals case file prior to C2C's reconsideration decision. Participation in the Formal Telephone Discussion Demonstration is voluntary. For additional information, visit the C2C website .
Last Updated Aug 01, 2017