QIC Part B North
C2C Innovative Solutions, Inc. (C2C) is a Qualified Independent Contractor (QIC) for Medicare Part B for 35 northern states, Washington DC, and three U.S. territories. This jurisdiction is referred to as Part B North.
For Part B North reconsideration requests please include all of the following items in your request for the reconsideration:
- The Medicare beneficiary's name
- The Medicare beneficiary's health insurance claim number (HICN)or Medicare number
- Specific service(s) and item(s) for which the reconsideration is being requested, and the specific date(s) each of those item(s) or service(s) were provided
- The name of the party (appellant) or the name of the authorized representative of the party (appellant). Note: As of July 8, 2019, the signature of the party or the signature of the authorized representative of the party is no longer a requirement for a request for reconsideration.
- The name of the Medicare contractor that rendered the Part B claim redetermination (first-level appeal decision)
Fillable Reconsideration Request Form is available for use.
Access FAQs on these Electronic Options for Submitting Medicare Fee-For-Service (FFS) Second-Level Appeals-Reconsiderations.
Choose one of these three ways to submit your appeal:
- You may securely fax your appeal to 904-539-4081 OR
- You may also submit your appeal and documentation to our appeals portal (Access a User's Guide.) OR
- You may mail your appeal to:
C2C Innovative Solutions - QIC Part B North
PO Box 45208
Jacksonville, Florida 32232-5208
If you have questions about the QIC Part B North appeals process, you may call us at 904-224-7426.