Maximus, the QIC contractor, is making one part of the appeal process a bit more orderly by using Zoom to conduct telephone discussions. Using a conference line will surely make participation easier for employees working remotely. And while Zoom is known for video conferencing, Maximus is using the platform’s traditional telephone conference line features only. Video is not an option ... a relief for the camera-shy.
Telephone discussions allow suppliers to present additional appeal information directly to QIC experts. The process is entirely voluntary, and the QIC does not guarantee a discussion for every case. The QIC will record calls, and the recordings become part of the case file that goes to the ALJ when a decision is unfavorable.
When suppliers opt for a discussion, the QIC can take up to 120 days to complete the appeal, compared to 60 days for on-the-record appeals. The QIC uses the extra days to coordinate a convenient time for the discussion and wait for additional evidence and documents that may come up during the discussion.
Previously, Maximus called suppliers directly at an appointed time. Now, when the contractor schedules a discussion, they send the requester an email with:
SOURCE LINKS
https://cgsmedicare.com/jc/pubs/news/2020/11/cope19570.html
https://www.medicaredmeappeals.com/telephone-discussion-process-overview
Telephone discussions allow suppliers to present additional appeal information directly to QIC experts. The process is entirely voluntary, and the QIC does not guarantee a discussion for every case. The QIC will record calls, and the recordings become part of the case file that goes to the ALJ when a decision is unfavorable.
When suppliers opt for a discussion, the QIC can take up to 120 days to complete the appeal, compared to 60 days for on-the-record appeals. The QIC uses the extra days to coordinate a convenient time for the discussion and wait for additional evidence and documents that may come up during the discussion.
Previously, Maximus called suppliers directly at an appointed time. Now, when the contractor schedules a discussion, they send the requester an email with:
- The time and date of the call.
- A conference line phone number to call.
- A passcode for the meeting.
SOURCE LINKS
https://cgsmedicare.com/jc/pubs/news/2020/11/cope19570.html
https://www.medicaredmeappeals.com/telephone-discussion-process-overview