Article Detail - JE Part B

Noridian has seen an increase of Reconsiderations sent to Noridian as second level appeals, instead of Qualified Independent Contractor (QIC) - C2C Innovative Solutions. Here are some tips to determine whether to submit a redetermination or a reconsideration, and where to send your information.

Redetermination

Did your office recently receive information on a remittance advice that the claim was denied for something other than a clerical error?

• Complete portal process for a Redetermination or;
• Fill out a Redetermination paper form

Reconsideration

Did your office recently receive a letter with an unfavorable decision or a Medicare Redetermination Notice with a decision not in your favor?  

• Qualified Independent Contractor - C2C Innovative Solutions
• Reconsideration process
• Complete the QIC portal process for a reconsideration or;
• Complete a Reconsideration paper form

Appeals Resources

• Noridian Part A and B Appeals Tutorials
• CMS Internet Only Manual (IOM), Publication 100-04 Medicare Claims Processing Manual, Chapter 29 Appeals of Claims Decision