There are five levels within the Medicare appeals process that a provider or beneficiary can utilize to address disagreements they may have with the decision on a claim. After a Redetermination has been filed and processed, an appellant (if dissatisfied with the result of the Redetermination) can progress to the second level of appeal, known as a Reconsideration. Reconsiderations are conducted by the Qualified Independent Contractor, or QIC, which is a separate entity from Railroad Medicare.
Your request must be submitted in writing by using the CMS 20033 form, (PDF, 180 KB). Reconsiderations must be filed within 180 days of receipt of the Redetermination letter. The QIC then has 14 days to acknowledge a reconsideration request. The acknowledgment letter will include a Medicare Appeal Number which you would use to check the status on the QIC website. Reconsiderations are to be processed within 60 days by the QIC.
Reconsiderations involving Palmetto GBA Railroad Medicare claims will be mailed to the QIC South at:
Part B South Operations
P. O. Box 183092
Columbus, Ohio 43218-3092