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Reconsideration

If you are dissatisfied with a Redetermination, you may go to the next level of appeal, called a Reconsideration. You must file the Reconsideration request within 180 days of the date of the Redetermination decision.

Time Limit for Filing Request

Monetary Threshold to be Met

Time Limit to Complete Request

Where to File

180 days from Redetermination receipt date

None

60 days from receipt date

Qualified Independent Contractor (QIC)

 

A Reconsideration may be requested and submitted to C2C Innovative Solutions, Inc. in one of two ways.

  1. Complete and submit the standard CMS 20033 – Medicare Reconsideration Request form
  2. Submit a written request containing at least the following information
    • Beneficiary's name
    • Medicare health insurance claim number
    • 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

Appeal Rights on Dismissals

  • Parties to Redetermination can appeal a dismissal to QIC
  • Reconsideration request must be filed within 60 days of dismissal date
  • Requestor may also ask us to vacate the dismissal
    • To vacate a dismissal, file a request within 6 months of dismissal letter receipt date. In request, explain why you believe to have good and sufficient cause for failing to include proper information in request

Send Reconsideration requests to:

C2C Innovative Solutions, Inc.
QIC Part B North Reconsiderations
PO BOX 45208
Jacksonville FL 32232-5208

Any questions about the QIC Part B North appeals process? Call them at 904-224-7426.

View the C2C Innovative Solutions, Inc. This link will take you to an external website.

Check the status of an appeal in the Q2 Administrators Appeals Status Lookup This link will take you to an external website. tool. 
 

Last Updated Nov 08, 2017