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:

1. The Medicare beneficiary's name
2. The Medicare beneficiary's health insurance claim number (HICN)or Medicare number
3. 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
4. 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.
5. 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.

Contact Us

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.