AdQIC

AdQIC: A Brief Refresher on the Role This Contractor Plays

(June 15, 2012): If you have ever been involved in a Medicare postpayment audit, or even a prepayment audit, you may have heard of the “QIC” – the Qualified Independent Contractor. This contractor for the Centers for Medicare & Medicaid Services (CMS) is responsible for adjudicating reconsideration appeal requests from appellants still unhappy with a […]

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Lose Your Appeal at Reconsideration? Consider an ALJ Hearing

(June 18, 2011): As a review of the last several quarters of Medicare appeals statistics reflects, an overwhelming percentage of Medicare providers appealing alleged overpayments through the Medicare administrative appeals process have chosen to “throw in the towel,” so to speak, when they have lost at the reconsideration level. As you will recall, at the

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Keeping an Eye on the Medicare AdQIC

(May 16, 2023): The Medicare program is enormous. The Centers for Medicare & Medicaid Services (CMS) estimates that Medicare Administrative Contractors (MAC) process 1.2 billion[1] fee-for-service claims each year in connection with the original[2] (or traditional) Medicare program. If you have ever been involved in a Medicare postpayment audit (or even a prepayment audit[3]) where

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