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What is the address to send the QIC appeal?

In order to submit your reconsideration in writing you will need to complete the CMS-20033 Medicare Reconsideration Request Form or the reconsideration request form included with the redetermination decision. Send the completed CMS-20033 Medicare Reconsideration Request Form to the QIC appeals mailing address:

C2C Innovative Solutions, Inc.- QIC Part B North
P.O. Box 45208
Jacksonville, FL 32232-5028