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QIC Part B South

C2C Innovative Solutions, Inc. (C2C) is a Qualified Independent Contractor (QIC) for Medicare Part B for 15 southern states, and two U.S. territories. This jurisdiction is referred to as Part B South.

QIC Part B South Map

For Part B South reconsideration requests please include all of the following items in your request for the reconsideration:

  1. The Medicare beneficiary's name
  2. The Medicare beneficiary's health insurance claim number (HICN) or Medicare number
  3. Specific service(s) and item(s) for which the reconsideration is being requested, and the specific date(s) each of those item(s) or service(s) were provided
  4. The name of the party (appellant) or the name of the authorized representative of the party (appellant). Note: As of July 8, 2019, the signature of the party or the signature of the authorized representative of the party is no longer a requirement for a request for reconsideration.
  5. The name of the Medicare contractor that rendered the Part B claim redetermination (first-level appeal decision)

 

Submit Your Appeal

Ways to submit your appeal:

 

If you have questions about the QIC Part B South appeals process:

Secure Electronic Submission of Standard Appeals

You may securely submit your appeal by fax or online through our appeals portal.

FAX
904-539-4090
C2C Solutions ISO Certified

For information about the availability of auxiliary aids and services, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html.

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