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Tag: QIC


Andrea Stark

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Andrea Stark makes case for making demo permanent

September 10, 2021Liz Beaulieu, Editor

YARMOUTH, Maine – The contract may be running out for a demonstration that allows HME providers to try to resolve denied claims by phone, but Andrea Stark says, “We’re onto something here,” and hopes CMS will make it a permanent part of the statement of work for the QIC.  The QIC, which is run by Maximus, recently announced it is winding down the demo per a contract that ends Dec. 31, 2021.  “Clearly, DME is complicated and suppliers feel better when...

Andrea Stark, Appeals, Home Medical Equipment, QIC


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QIC will transition from C2C to Maximus

June 28, 2019HME News Staff

WASHINGTON - C2C Innovative Solutions has lost its bid to remain CMS's Qualified Independent Contractor for HME, according to AAHomecare.Jacksonville, Fla.-based C2C has popularized a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases.Last year, when CMS awarded the new QIC contract to Reston, Va.-based Maximus, C2C protested.C2C will offer its last phone discussion on Sept. 15 and will complete all decisions by Dec....

Audits, C2C, Contract, QIC


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CMS expands phone demo

October 23, 2018HME News Staff

JACKSONVILLE, Fla. - CMS will expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases to jurisdictions A and B on Nov. 1.The agency cited “strong support from the supplier community and the initial success of the demonstration” as reasons to expand the phone demo.“Effective on or after Nov. 1, the DME QIC will offer telephone discussions and/or re-openings to DME suppliers within the DME MAC Jurisdictions...

ALJ, Appeals, C2C Innovative Solutions, Phone demo, QIC


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Appeals update: Pressure mounts to expand phone demo

December 15, 2017Liz Beaulieu, Editor

WASHINGTON - CMS is considering expanding a demonstration project to jurisdictions A and B that allows providers to speak with reconsideration professionals by phone to try and resolve their appeals at the second level, stakeholders say.After hearing testimony from Ronda Buhrmester at a recent Small Business Administration hearing, CMS responded in a letter, saying it “concurs with the noted initial benefits of this demonstration and is in discussions regarding possible expansions to jurisdictions...

Appeals, C2C, Phone demo, QIC


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Not so QIC

March 11, 2016Liz Beaulieu, Editor

JACKSONVILLE, Fla. - Certain HME providers will now have a voice at Medicare's second level of appeals as part of a new demonstration project.C2C Innovative Solutions, Medicare's Qualified Independent Contractor or QIC, has launched a demo project that allows providers in Jurisdictions C and D to speak with a reconsideration professional by phone to try and resolve their cases.“This is the first real solution that anyone has brought forward that could potentially have an impact on reducing...

ALJ Backlog, Andrea Stark, C2C Innovative Solutions, QIC, Wayne van Halem


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In brief: Appeals process, acquisitions and readmissions

November 16, 2012HME News Staff

WASHINGTON - The Office of Inspector General (OIG) recommends “coordinated training” for administrative law judges (ALJs) and qualified independent contractors (QICs) on the Medicare appeals process in a new report. The OIG has found that the ALJs, which administer the third level of appeal, reversed 56% of the decisions by the QICs, which administer the second level of appeal. This trend, according to the OIG, is due to different interpretations of Medicare policies and other factors....

ALJ, OIG, QIC


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Also Noted

OIG study: Appeals process lacks clarity, consistency

November 15, 2012HME News Staff

WASHINGTON - The Office of Inspector General (OIG) recommends “coordinated training” for administrative law judges (ALJs) and qualified independent contractors (QICs) on the Medicare appeals process in a new report. The OIG has found that the ALJs, which administer the third level of appeal, reversed 56% of the decisions by the QICs, which administer the second level of appeal. This trend, according to the OIG, is due to different interpretations of Medicare policies and other factors....

ALJ, CMS, OIG, OMHA, QIC


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