tci Medicare Compliance & Reimbursement - 2008 Issue 28

Appeals: Part B QICs Missed 58 Percent Of Appeals Deadlines

54 percent of QIC appeals included wrong information, OIG says. If you've been relying on the Medicare Qualified Independent Contract (QIC) program to take care of your appeals in a timely fashion, the OIG has bad news. Two years ago, CMS changed the appeals process, ensuring that you'll first appeal a claim to your carrier, followed by filing a reconsideration appeal to the QIC, and then if that doesn't pan out, you can appeal at the administrative law judge (ALJ) level. Although the new process constituted a change to the way practices were used to appealing, some analysts were...

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