Current Style: Standard
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- Demonstration/Phone Discussion
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Current Style: Standard
MAXIMUS Federal Services is a Qualified Independent Contractor (QIC) for Medicare Durable Medical Equipment (DME) claims for all DME jurisdictions. For information on how to file a DME reconsideration request please refer to “How to file an appeal” under the Medicare Appellants option.
The telephone discussion process under the Demonstration allows suppliers and QIC reconsideration experts to communicate during the reconsideration period and present additional details or information that will assist with the appeal review.
Upon receipt of a valid reconsideration request for a DME claim, MAXIMUS Federal will identify appeals that would benefit from the telephone discussion process. All appeals are eligible for this process except for:
The telephone discussion process will have the following objectives:
If an appeal is selected for participation in this process, MAXIMUS Federal will send the supplier an invitation letter through the mail, identifying a day and time for the telephone discussion to be conducted. The telephone discussion process is voluntary, and if the supplier chooses not to participate, the standard reconsideration appeal process will continue.
If the supplier wishes to participate, a response via secure fax (preferred), mail or phone is required within 14 days. The scheduling letter will contain appropriate contact information, which is also included on this website. An alternative date and/or time that suits both parties may be chosen if required.
MAXIMUS Federal will contact the supplier prior to the scheduled date as a reminder of the appointment. At the scheduled time, the QIC reconsideration expert will contact the supplier’s representative to conduct the telephone discussion. This discussion will be recorded and included as part of the administrative case file forwarded to the OMHA.
As part of the Demonstration process, for those appeals in which the supplier chooses to participate, the QIC will extend its timeframes for making a reconsideration decision to 120 calendar days (rather than the usual 60 days). This allows time for the telephone discussion and delivery of any required information.