Medicare Financial Management Manual (Pub. 100-06), Ch. 7 § 50.3

C Controls – Appeals

Last amended: 2018Year: 2018Length: 203 wordsOfficial source
50.3 – C Controls – Appeals (Rev. 308, Issued: 10-26-18 Effective: 09- 01- 18, Implementation: 11-27-18) C – Control Number Control Objective – Appeals C.1 Medicare Part A and Part B redeterminations processed by MACs are processed based on CMS instructions, appropriately logged and completed within legislatively mandated time frames and tracked to meet CMS guidelines. (Does not pertain to MSPRC. Refer to C.3 for MSPRC control objective.) C.2 Medicare Part B redeterminations processed by MACs are processed based on CMS instructions, appropriately logged and completed within legislatively mandated time frames and tracked to meet CMS guidelines. (Does not pertain to MSPRC. Refer to C.3 for MSPRC control objective.) C.3 Redeterminations processed by the MSPRC are processed based on CMS instructions, appropriately logged and completed within legislatively mandated time frames and tracked to meet CMS guidelines. C.4 Qualified Independent Contractor (QIC) request for case files are handled in compliance with CMS time frames. C.5 Effectuations are processed as directed by CMS guidelines. C.6 Contractor communications are clear and in compliance with CMS’ instructions to include specific communications such as acknowledgement letters, decision letters, and information on additional appeal rights, etc. End Section 50.3 – C Controls – Appeals: Back to Table of Contents