Quality Improvement Organization Manual (Pub. 100-10), Ch. 5 § 5055.5

Beneficiary Complaint: No Response to Opportunity for Discussion

Last amended: 2016Year: 2016Length: 81 wordsOfficial source
5055.5 – Beneficiary Complaint: No Response to Opportunity for Discussion (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) If no response is received regarding the offer of the Opportunity for Discussion within seven (7) calendar days or the practitioner/provider agrees with findings, the Interim Initial Determination becomes the Final Initial Determination. The Initial Determination Peer Reviewer need not sign the QRD Form again to denote this result; however, the QIO will note on the QRD Form that no response was received.
Quality Improvement Organization Manual (Pub. 100-10), Ch. 5 § 5055.5: Beneficiary Complaint: No Response to Opportunity for Discussion | Justis AI