Tuesday, May 19, 2020

Enhanced Opportunity for Submission of 2nd Level Appeals, Reconsiderations

Dan Ciolek

On May 7, 2020, the Centers of Medicare and Medicaid Services (CMS) posted enhanced flexibilities for providers to submit 2nd level Medicare Fee-For-Service (FFS) claim appeals (reconsiderations) to Qualified Independent Contractors (QICs). Specifically, CMS has established alternative communication mediums for stakeholders to submit reconsideration requests and related documentation to the QIC. The websites for the respective QIC jurisdictions contain instructions to stakeholders for electronic (e.g., fax or portal) submission of reconsideration requests or documentation. Guidance regarding the options for submitting reconsiderations and related documentation is also summarized by QIC jurisdiction as posted here

Note: implementation of these alternative mechanisms does not preclude providers from ongoing submission of 2nd level appeals via hard copy mail. Please share this information with your claim appeals staff.

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