Beneficiary Complaint: Procedures for Closing a Complaint Review

5060.4 – Beneficiary Complaint: Procedures for Closing a Complaint Review (Rev. 28, Issued: 10-21-16, Effective: 10-21-16, Implementation: 10-21-16) The QIO must denote in the CMS-designated or otherwise approved case review system that the beneficiary complaint is completed and closed. The QIO may determine that Post-Review Advocacy, a post-peer review alternative dispute resolution process, should be made available to the beneficiary. (See §5065). The QIO must place all final documents in the Beneficiary Complaint folder/file and maintain this hard copy or electronic file in accordance with Manual Chapter 13. The QIO may pursue Quality Improvement Initiatives in accordance with §5125 or Post-Review Advocacy in accordance with §5065, if deemed appropriate.