Which QIC receives the reconsideration?

Use the claim type and QIC jurisdiction on the actual Medicare Redetermination Notice. Residence alone does not select a QIC. These are CMS-listed standard Original Medicare provider reconsideration channels, not Part D or Medicare Advantage appeal destinations.

Part A East

Standard provider-side second-level Original Medicare Part A East QIC reconsideration requests and related documentation, after an actual redetermination on the merits. Not PartD, PartC, a MAC dismissal review, an expedited beneficiary QIO/service-termination case or a first-level MAC appeal. Confirm the actual QIC instructions before transmitting any case materials.

Source verification required. Contractor/channel details are withheld until the source is checked.

Official CMS source — CMS second-level appeal page — Electronic Submission of Reconsideration Request table, Part A East row · checked 2026-10-15

Part A West

Standard provider-side second-level Original Medicare Part A West QIC reconsideration requests and related documentation, after an actual redetermination on the merits. Not PartD, PartC, a MAC dismissal review, an expedited beneficiary QIO/service-termination case or a first-level MAC appeal. Confirm the actual QIC instructions before transmitting any case materials.

Source verification required. Contractor/channel details are withheld until the source is checked.

Official CMS source — CMS second-level appeal page — Electronic Submission of Reconsideration Request table, Part A West row · checked 2026-10-15

Part B North

Standard provider-side second-level Original Medicare Part B North QIC reconsideration requests and related documentation, after an actual redetermination on the merits. Not PartD, PartC, a MAC dismissal review, an expedited beneficiary QIO/service-termination case or a first-level MAC appeal. Confirm the actual QIC instructions before transmitting any case materials.

Source verification required. Contractor/channel details are withheld until the source is checked.

Official CMS source — CMS second-level appeal page — Electronic Submission of Reconsideration Request table, Part B North row · checked 2026-10-15

Part B South

Standard provider-side second-level Original Medicare Part B South QIC reconsideration requests and related documentation, after an actual redetermination on the merits. Not PartD, PartC, a MAC dismissal review, an expedited beneficiary QIO/service-termination case or a first-level MAC appeal. Confirm the actual QIC instructions before transmitting any case materials.

Source verification required. Contractor/channel details are withheld until the source is checked.

Official CMS source — CMS second-level appeal page — Electronic Submission of Reconsideration Request table, Part B South row · checked 2026-10-15

DME

Standard provider-side second-level Original Medicare DME QIC reconsideration requests and related documentation, after an actual redetermination on the merits. Not PartD, PartC, a MAC dismissal review, an expedited beneficiary QIO/service-termination case or a first-level MAC appeal. Confirm the actual QIC instructions before transmitting any case materials.

Source verification required. Contractor/channel details are withheld until the source is checked.

Official CMS source — CMS second-level appeal page — Electronic Submission of Reconsideration Request table, DME row · checked 2026-10-15

Separate the filing task from the channel

Confirm that the decision is a merits redetermination. MAC dismissals use a separate QIC review procedure, and expedited beneficiary service-termination cases following QIO review use other instructions. A fax/portal listed for standard provider appeals must not be substituted for those processes.

Before sending case materials, verify the actual notice, party or representative role, selected jurisdiction and current channel instructions. Preserve submission evidence in the secure case system. IntelClaim does not accept patient identifiers, log into an external portal or file an appeal.

QIC merits reconsideration filing window · Prepare, save and export a provider QIC checklist · All supported appeal routes.