Redetermination Versus Reconsideration Forms - Appeals Newsletter Part 18

The Appeals team has identified that incorrect forms are being submitted for appeals. To ensure appeals are processed efficiently, it is critical to use the correct forms and submit them to the appropriate location. This article provides a summary of where appeals should be sent and which forms must be used for redeterminations and reconsiderations. To avoid submitting the incorrect form, Noridian encourages all providers to submit their appeals through the Noridian Medicare Portal (NMP).

Redetermination

  • Redetermination Form
    • Send to:
      Redeterminations Medicare Part B
      Attn: Redeterminations
      PO Box (Select from table on form)
      Fargo, ND 58108-(Select from table on form)
    • Fax Redetermination requests to: 701-277-7852

Reconsideration

  • C2C QIC Part B North
  • Reconsideration Form
    • Send to:
      C2C Innovative Solutions, Inc.
      QIC Part B North Reconsiderations
      PO Box 45208
      Jacksonville, FL 32232-5208
    • Fax Reconsideration requests to: 904-539-4081

Appeals Resources

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