Quality Improvement Organization Manual (Pub. 100-10), Ch. 5 § 5055.5
Beneficiary Complaint: No Response to Opportunity for Discussion
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.