General Information Guide

Reconsideration (Second Level of Appeal)

A written reconsideration request must be filed with a QIC within 180 days of receipt of the redetermination. When providers receive an unfavorable redetermination, providers shall follow the instructions on your MRN.

To request a reconsideration, please complete the CMS-20033 Medicare Reconsideration Request Form or the Reconsideration Request Form included with the redetermination decision and send to the QIC appeals mailing address:

C2C Innovative Solutions, Inc. ‒ QIC Part B North
P.O. Box 45208
Jacksonville, FL 32232-5208

C2C Innovative Solutions, Inc. website

For additional details for the second level of appeal visit Submit a Reconsideration.

For information about all levels of appeals visit the CMS Original Medicare (Fee-for-Service) Appeals web page.

Reviewed 10/21/2024