Medicare Part C QIC Reconsiderations Contact Form

This contact form is for Medicare Advantage (MA) Organizations, Medicare Cost Plans, Health Care Prepayment Plans (HCPPs) and Program of All-Inclusive Care for the Elderly (PACE) Organizations providing Medicare Part C items, services and Part B drugs.

Each Plan must complete the form below to designate one or two key organizational contact(s) for general appeal-related communications and escalated case-specific concerns.

Note: For routine case-specific activities, C2C Innovative Solutions, Inc. will communicate with the contact identified in the Part C Reconsideration Background Form for the respective appeal.