Wednesday, April 16, 2014

Quality to the Next Level

Important News for Beneficiaries: Jimmo Re-Review Information

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On January 24, 2013, the U.S. District Court for the District of Vermont approved a settlement agreement in the case of Jimmo v. Sebelius (Jimmo). The Jimmo settlement agreement provides for the re-review of certain Medicare claims under clarified maintenance coverage standards for the skilled nursing facility (SNF), Home Health (HH), and Outpatient Therapy (OPT) benefits. These benefits apply when a patient requires such services to maintain, or to prevent or slow further deterioration of, the clinical condition.

Beneficiaries, please click on the link below to access the proper form for requesting a re-review of your claim pertaining to the Jimmo settlement:

 

Request for Re-Review of Medicare Claims Related to the Settlement Agreement in Jimmo V. Sebelius

  

Appeals Status Lookup Experiencing Issues

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The AdQIC Web site's Appeals Status Lookup feature has encountered an issue with the database it uses to store appeals status information. Some appeal numbers may return with a status, other appeals may not. A problem ticket has been submitted and a fix is forthcoming. We have not been given a time frame for a solution.

Please continue to check q2a.com periodically to see if the issue has been corrected. We apologize for your inconvenience.

  

Who We Are

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About Q2A

Q2Administrators, LLC ( Q2A ) is one of eight Qualified Independent Contractors (QICs) chosen by the Centers for Medicare & Medicaid Services (CMS) to implement a new system for appealing Medicare claim denials. Congress mandated the new system to provide more timely and accurate dispositions of Medicare appeals.

The new appeals process was established in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) and modified by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). The laws created QICs to conduct reconsiderations of Medicare claim denials made by Part A, Part B and Durable medical equipment (DME) Medicare administrative contractors (MACs), and quality improvement organizations (QIOs). The legislation also established uniform appeals procedures for both Part A and Part B claims, and reduced the amount of time appeals reviewers have to make decisions.

CMS assigns responsibilities to the QICs by awarding task orders. In 2004, Q2A won the Administrative QIC (AdQIC) task order, which was the first task order awarded under the new system. From its headquarters in Columbia, S.C., Q2A provides administrative support as the AdQIC to CMS and the other QICs by:

  • Developing training and standard work protocols
  • Analyzing appeal outcomes
  • Recommending improvements to the appeals process
  • Managing case files

In 2006, Q2A was awarded the Part B South contract. The Columbus, Ohio, office processes Part B reconsiderations for the Southern United States.

Our mission

The mission of Q2A is to provide support and services to the federal government and other customers that reflect our ideal of "Quality to the Next Level." Q2A delivers consistent, quality outcomes and solutions for our customers by utilizing sound processes and a stringent quality assurance program. Our foundation is an experienced group of associates who have created a culture emphasizing innovative ideas and quality customer service.

Q2A Contact Information

Part B South QIC Mailing Address

Part B South QIC Courier Address

Q2Administrators, LLC

Part B South QIC Operations
PO Box 183092
Columbus, OH 43218-3092

Q2Administrators, LLC

Part B South QIC Operations

5150 East Dublin-Granville Rd
Westerville, OH 43081

AdQIC Mailing Address

AdQIC Courier Address

Q2Administrators, LLC

AdQIC Operations
300 Arbor Lake Drive
Suite 1350
Columbia, SC 29223-4582

Q2Administrators, LLC

AdQIC Operations
300 Arbor Lake Drive
Suite 1350
Columbia, SC 29223-4582

  

Appeals Status Lookup

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Helpful Links

 

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