Beneficiary Complaint: Follow-up – Return of Signed Medicare Quality of Care

5040.2 – Beneficiary Complaint: Follow-up – Return of Signed Medicare Quality of Care Complaint Form (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) If the signed Complaint Form is not received within fourteen (14) calendar days of the date of the mailing, faxing, or emailing of the form, the QIO should follow up with the beneficiary. The QIO should determine if the beneficiary still intends to file a written complaint. The QIO should do this no later than calendar day fifteen (15) or the next business day following the 15th day after the date the Complaint Form was forwarded. Upon contact, if the beneficiary continues to indicate a desire to file a written complaint, the QIO should work with the beneficiary to determine any additional steps necessary to ensure return of a signed Medicare Quality of Care Complaint Form, including forwarding another Medicare Quality of Care Complaint Form. If the beneficiary no longer intends to file a written complaint or after additional follow-up the beneficiary fails to comply with the beneficiary review process and does not submit the signed Medicare Quality of Care Complaint Form by calendar day thirty (30), then the QIO may follow instructions provided in § 5040.4 (Beneficiary Complaints: Complaints Not Submitted in Writing) and Section 5040.5 (Beneficiary Complaint: Abandoned Complaints and Reopening Rights). If the beneficiary is advised that the case will be considered abandoned and closed, the beneficiary may submit the signed Medicare Quality of Care Complaint Form at any time if he/she chooses to submit a written complaint to initiate the compliant review process.