US · guidance
CMS Pub. 100-04, ch. 30, § 300.1
The Role of the Beneficiary and Liability
Submitting a Request: A beneficiary who chooses to exercise the right to an expedited
reconsideration must submit a request to the appropriate IRE in writing or by telephone
no later than noon of the calendar day following the initial notification (whether by
telephone or in writing) of the QIO’s determination. The beneficiary, upon request of the
QIO, should be available to discuss the case or supply information that the IRE may
request. The beneficiary may, but is not required to, submit written evidence to be
considered by the IRE.
Untimely Requests: When the beneficiary fails to make a timely request for an
expedited reconsideration subsequently may request a reconsideration under the standard
claims appeal process (See Chapter 29 of this Manual), but the coverage protection
described in Section 300.5 would not extend through this reconsideration, nor would the
notification timeframes or the escalation process described in Section 300.2 apply.
History
(Rev. 1257, Issued: 05-25-07; Effective: 07-01-07; Implementation: 07-02-07)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
b9156bc01a6fb8c1ae508057907e945bd1b537145daa1ebf538c47a7fdd31013
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