Eligibility for Beneficiary Complaint Review

5025.1 – Eligibility for Beneficiary Complaint Review (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) For a complaint to be eligible for a Beneficiary Complaint Review (see §§5040 – 5055.7), ALL of the following requirements must be met. The complaint must: 1. Relate to the quality of care received by a beneficiary, regardless of whether the beneficiary or Medicare paid for the care, but for which payment may otherwise be made under title XVIII; 2. Be written (includes email, facsimile, or hard-copy submission); and 3. Express concern about the quality of care received. NOTE: See §5040.4 (Beneficiary Complaint: Complaints Not Submitted in Writing) for oral complaints.