The telephone discussion process allows suppliers to discuss the facts of the case with the QIC and to submit any missing/critical documentation identified by the QIC, as needed, to support a favorable resolution, prior to the QIC rendering a decision. Participation in the telephone discussion is voluntary. Eligible providers and suppliers are offered the opportunity to engage in a recorded telephone discussion of appealed claims with the QIC prior to the issuance of the reconsideration decision. Settlement Conference Facilitation) are not eligible for telephone discussions and/or reopenings under the Demonstration. Under the Demonstration, the QIC reviews reconsideration requests to identify appeals that may benefit from participation in the telephone discussion process. Reconsiderations for service termination, hospital discharge reviews and claims or providers that are already involved in another CMS initiative (e.g.
File extension qic mac#
On May 1, 2019, the Demonstration was expanded to the Part A East QIC Jurisdiction to include all Part A claim types within MAC Jurisdictions H, J, K, L, M, and N, and home health and hospice (HHH) related appeals within MAC Jurisdictions J6 and J15. However, on October 1, 2016, CMS expanded the Demonstration to include all DME claim types within DME MAC Jurisdictions C and D, with exception to claims or suppliers that were already subject to another Centers for Medicare & Medicaid Services (CMS) initiative (e.g., Prior Authorization for Power Mobility Devices (PMDs), Settlement Conference Facilitation (SCF)).
This Demonstration initially focused on oxygen and glucose/diabetic testing strip supplies. On January 01, 2016, CMS launched a QIC Telephone Discussion and Reopening Process Demonstration to test whether further engagement between Durable Medical Equipment (DME) suppliers and the DME QIC will improve the understanding of the cause of appeal denials, and over time, result in more proper claim submission at the DME MAC level from suppliers participating in the Demonstration. Update: CMS Expands the Demonstration to Part A Demonstration Background: These questions may be addressed during the call or used for other materials following the call. A question and answer session will follow the presentation however attendees may email questions in advance to with "Appeals Demonstration" in the subject line.
File extension qic registration#
The registration for the March 5 th call can be found at. Part A providers located in these areas may participate in the Demonstration however, any Part A provider may attend.
File extension qic how to#
On March 5, 2020, CMS will host a Medicare Learning Network Provider Call to offer Part A providers information on the QIC Appeals Demonstration process, how to identify if they are eligible, and how to participate. FebruMedicare Learning Network Provider Call Announcement The Demonstration activities will now continue through December 31, 2021. Aug– CMS Announces Approval for One Year Extension on Existing Activities Related to the Medicare Appeals DemonstrationĬMS recently received approval for a one-year extension of the QIC Telephone Discussion and Reopening Process Demonstration activities in the DME QIC and Part A East QIC jurisdictions. We thank you for your interest and participation. This includes activities conducted by both the Durable Medical Equipment (DME) and Part A East QIC contractors. Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration J- Reminder of Demonstration End DateĪs a reminder, all activities related to Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration will be ending December 31, 2021.
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