Electronic Options for Submitting Medicare Fee-For-Service (FFS) Second-Level Appeals-Reconsiderations

Q. What options are available for appellants to submit QIC reconsideration requests during the COVID-19 Public Health Emergency (PHE)?
A. The Centers for Medicare & Medicaid Services (CMS) has approved C2C's request to expand our faxing solution with sufficient capacity, as well as a portal solution to ensure Medicare beneficiaries and providers have the continued ability to electronically submit Medicare Fee-For-Service (FFS) second-level claim appeals and related documentation to C2C during this PHE.

Q. Why is there a sudden need for an alternative method for beneficiaries and providers to submit appeal requests and associated correspondence?
A. In response to the PHE, C2C is taking proactive measures to ensure the safety of employees, while also promoting the continuity of mailroom and business operations for processing Medicare QIC reconsiderations. As of April 3, 2020, C2C's mailroom operations and support services will be limited. In the event that our staff is prohibited from accessing our building altogether, these new alternative methods will immediately position us to continuously receive, control, monitor and process Medicare appeals from a remote environment. Your utilization of these electronic alternative methods will allow our timely processing of your appeal.

Q. What is the effective date for these new solutions?
A. The expanded fax solution and simple portal should be available on or before 4/3/2020.

Q. How is this information being communicated to the community?
A. In addition to its website, C2C has updated our public voice mail for each of our QIC operations and we have mailed communication to providers who have submitted appeals within the last year. C2C has also provided an informational bulletin for the MACs to distribute via their Listserv.

Q. What are the benefits to using the portal?
A. The portal provides you with free, secure, real-time, internet-based access to electronically submit your appeal and receive an immediate confirmation that the transmission was successful. In addition to the portal, the fax option provides the means for you to submit your appeal by fax if you prefer. Both options provide the ability to avoid paper usage and cost of postage. The confirmation of submission can also help prevent the filing of duplicate reconsideration requests. We ask that you do not submit duplicate appeal requests as that will delay the processing of your appeal.

Q. Does the portal offer the opportunity to check the status of my reconsideration?
A. No. This portal only receives your documents. It cannot be used for any other purpose.

Q. What action do I take if I have additional documentation or a correction to make after I have already submitted the reconsideration? If I have additional correspondence or documentation, in addition to the appeal request form, will I be able to upload these records or documents to support the appeal?
A. You may submit your documentation through the portal or fax, but please clearly indicate on the cover that it is additional information for a previously submitted appeal and include the appeal number, if available, to facilitate timely processing. If the appeal number is not available, please include additional information that will assist in ensuring they are matched to the appropriate reconsideration request. Examples of additional information include, but are not limited to the reconsideration number and claim number.

Q. If I do not have additional documentation other than what was previously submitted to the MAC for review, will I be able to complete the appeal request and/or appointment of representation form online, or will I need to convert a signed copy to a digital file?
A. Yes. Our website includes a fillable PDF form for the reconsideration request. Reconsideration requests no longer must be signed. However, AORs must be signed and faxed or converted to a digital file, such as a PDF, to upload.

Q. Will the customer-service callback line be operational during the PHE?
A. Yes. C2C will continue to return phone calls and process telephone inquiries within one business day of receipt.

Q. How do I receive confirmation that the QIC received my reconsideration request? Will I receive a reference or validation number to confirm receipt for additional records submitted? How do I verify or receive the outcome of my QIC reconsideration?
A. You will continue to receive a hardcopy acknowledgement of our receipt, as well as the QIC reconsideration decision. If you submit your appeal by fax, your fax confirmation serves as your confirmation. If you submit to our portal, the portal will return a message of a successful transmission and an email confirmation will be sent to the email address used to register. If by the 20th day after your submission, you have not received an acknowledgement letter, you may call to check on the status. You may also check the Administrative QIC website at www.Q2A.com.

Q. What fax numbers do I use to submit my reconsideration?
A. Please refer to the specific page on our website for appeals that pertain to the jurisdictions of: QIC Part B North, QIC Part B South, or QIC Part A East.

Q. How can I access your portal?
A. Go to our website at www.C2Cinc.com and locate the link to the portal on our home page, the QIC Part B North page, QIC Part B South page or QIC Part A East page.

Q. How will I receive ongoing updates about the status of QIC operations and the ability to resume hardcopy submission?
A. Please check C2C’s website as needed and continue to follow the guidelines and recommendations from CMS, the CDC, and other federal, state and local authorities. When the PHE is over and our mailroom staff is cleared to return to the office, our website will be updated and a Listserv will share the announcement as well.

Q. What will the turnaround time be for processing my QIC reconsideration during this PHE?
A. C2C remains committed to processing reconsiderations as quickly as possible without affecting the timeliness and quality standards that Medicare stakeholders have come to expect.

Q. How do I enroll for the portal?
A. When you visit the portal page, you will be prompted to enter your email address. The portal will check if you are already registered. If you are already registered, you will be prompted to login using the user ID and password 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 such as your organization name and phone number, your email address (which will serve as your user ID) and a password that you select. Instructions on how to enroll and use the portal are provided on the portal page.

Q. What options do I have for submitting my appeal requests if I am unable to use the fax or portal options?
A. If you are not able to submit your QIC reconsideration via fax, a faxing software on your computer or through the internet portal, you may continue to submit by paper. If our mailroom is not able to receive paper receipts during this PHE, we will apply good cause for late processing of your appeal upon our return to the office and are able to accept US Postal Service mail or courier services.