Solicitation of Views Regarding Hospital-Issued Notice of Non-

7020 - Solicitation of Views Regarding Hospital-Issued Notice of Non- coverage - (Rev. 4, 07-18-03) A. Beneficiary's Views When you conduct a review either because the beneficiary or his/her representative requests one (See §7015.B.1) or the hospital requests your review because the attending physician does not agree with its decision to issue a notice of non-coverage (See §7005.B.2), solicit the views of the beneficiary or his/her representative. This may be done by telephone. Present information solicited to the physician reviewer for use in the review. Also, make the information part of your case file. Solicit the views of the beneficiary or his/her representative at the same time as his/her telephone request for review to minimize the burden on the beneficiary. Make every attempt to contact the beneficiary or his/her representative within the timeframe allotted for review completion. If the beneficiary or his/her representative cannot be contacted by the end of the first full working day after the request for review and receipt of the medical record, make your review determination without the beneficiary's or his/her representative's views. Retain documentation of your attempts to contact the beneficiary/representative. B. Discussion With the Hospital and Attending Physician Give the attending physician and provider the opportunity to discuss the case prior to your determination, whether it will be adverse or favorable. Make every attempt to contact the hospital and attending physician before you make a determination.