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.
- Complete and submit the standard CMS 20033 - Medicare Reconsideration Request form
- 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.
Check the status of an appeal in the Q2 Administrators Appeals Status Lookup tool.
Last Updated May 21, 2018