Electronic Options for Submitting Medicare Part A and Part B Second-Level QIC Appeal Reconsiderations
Question 1. What options are available for appellants to submit a QIC reconsideration?
Answer: Appellants may fax an appeal request to the fax number that is listed within the appropriate QIC’s tab that is located at the top of this website. Appellants may also submit an appeal request using our appeals portal, which is located on the Home tab of this website. Either of these methods allow us to receive your appeal request and begin to process your appeal.
Question 2. What are the benefits to using the portal?
Answer: The portal provides you with free, secure, real-time, internet-based access to electronically submit your appeal, as well as receive an immediate confirmation that the documentation was received. In addition to the portal, the fax option provides an alternate way for you to submit your appeal by fax. Both options avoid paper usage and the cost of postage. The immediate submission confirmation that you will receive when using the portal or fax option also avoids the filing of duplicate appeal requests. Submitting duplicate appeal requests will delay the processing of your appeal.
Question 3. Does the portal offer the opportunity to check the status of my reconsideration?
Answer: No. This portal only receives your appeal request and any supporting documents you submit.
Question 4. What action do I take if I have additional documentation or a correction to make after I have already submitted my reconsideration request by fax or portal?
Answer: If you have additional correspondence or documentation that you want to include with your appeal, but you have submitted your initial appeal request, you should follow the following procedures. First, you must clearly indicate on your cover page that the information is “Additional Information” for a previously submitted appeal. Include the appeal number that was assigned (based on the acknowledgment letter we send to you within 14 days). If that is not available, still indicate it is “Additional Information” for a previously submitted appeal and include other information such as the name of the first-level Medicare Administrative Contractor (MAC), the claim number, beneficiary name, date of service, redetermination number or other information that was included on your initial reconsideration request that was previously submitted. This information will assist us and ensure your additional documentation is matched to your prior reconsideration request submission. It will ensure this information is reviewed as a total appeal package and facilitate timely processing.
Question 5. If I do not have additional documentation other than what was previously submitted to the MAC at the first level of appeal, will I be able to complete the reconsideration appeal request and, if applicable, complete an Appointment of Representation (AOR) form online?
Answer: Yes. Our website includes a fillable PDF form for the reconsideration appeal request. Reconsideration requests do not have to have to be signed; however, the AOR must be signed. A signed AOR can be faxed to the QIC or signed and converted to a digital file, such as a PDF, and then uploaded to the appeals portal located on the Home tab of this website. If an AOR was not submitted with your reconsideration request to the QIC, please see Question 4 above.
Question 6. If I need to leave a message on the customer-service callback line, when can I expect a call back?
Answer: C2C returns phone call messages within 24 hours or one business day of receipt.
Question 7. How do I receive confirmation that the QIC received my reconsideration request? Will I receive a reference or validation number to confirm receipt for any additional records that I submitted?
Answer: You will be mailed an acknowledgement letter, confirming our receipt of your appeal request within 14 days of the reconsideration request (please allow 5 days mail time before requesting confirmation that the appeal was received). If by the 20th day after you mailed your appeal request, you have not received an acknowledgement letter in the mail, you should call us to check on the status of your request.
If you submit your appeal by fax, your fax confirmation serves as your confirmation that we received your appeal request. If you submit your appeal request through our portal, the portal will provide you with a successful transmission notification, as well as sending you an email confirmation to the email address that was used to register for the portal. You may also check the Administrative QIC’s website at www.Q2A.com for a status.
Question 8. How do I verify or receive the outcome of my QIC reconsideration?
Answer: The QIC reconsideration decision will be mailed to the appellant when the review of the appeal has been completed, usually by the 60th day of the QIC’s receipt of it (please allow 5 days mailing time before requesting confirmation that the appeal was completed). You may also check the Administrative QIC’s website at www.Q2A.com for a status.
Question 9. What fax numbers do I use to submit my reconsideration?
Answer: For the QIC’s fax number, please refer to the specific tab at the top of this website to identify the appropriate jurisdiction for your appeal: QIC Part B North, QIC Part B South or QIC Part A East.
Question 10. How can I access your portal?
Answer: This website, www.C2Cinc.com, has a link to the portal on the Home page tab. The portal link is also listed within the tabs for the QIC Part B North, the QIC Part B South and the QIC Part A East.
Question 11. What will the turnaround time be for processing my QIC reconsideration?
Answer: C2C remains committed to processing reconsiderations as quickly as possible, meeting the timeliness and quality standards that Medicare stakeholders have come to expect. For standard Medicare Part A or Part B appeals, your appeal should be completed within 60 calendar days.
Question 12. How do I enroll for the portal?
Answer: When you visit the portal page, you will be prompted to enter your email address. The portal will check if you are a registered user. If you are already registered, you will be prompted to login using the user ID and password that you selected during registration. If you have not registered, you will be prompted to complete the online registration to establish an account. The registration form includes basic information about yourself and your organization, if applicable. Your email address will serve as your user ID and you must create a password. Instructions on how to enroll and use the portal are provided on the Home page through the portal’s User’s Guide.
Question 13. What options do I have for submitting my appeal requests if I am unable to use the fax or portal options?
Answer: If you are unable to submit your QIC reconsideration appeal request via fax or a faxing software on your computer or using the internet portal, you may submit your reconsideration request by completing the paper form and mailing it to the appropriate QIC jurisdiction. The mailing address for each QIC jurisdiction is provided within each QIC jurisdiction’s page located at the top of this website, as well as in the Contact section of this website.
Question 14. What happens if I forgot my portal password?
Answer: If you do not remember your password, select the reset password option once you entered your user name, which is the email address that you initially used to register to use the portal. The portal will send you an email with a link to a page that will enable you to reset your password. Passwords must be at least eight characters long and contain at least one number.