Working Out the Kinks of NOMNCs and QIO Appeals

The Quality Improvement Organization (QIO) reviews thousands of appeals annually. In 2019, approximately 50% of Florida appeals submitted were terminated due to technical failures which were often the fault of the submitting provider. These failures can result in substantial revenue loss to the provider. Multi-faceted, these failures include issues with the Notice of Medicare Non-Coverage (NOMNC), records submission, and meeting deadlines. This session reviews the basics of NOMNCs, how to respond to a QIO appeal request, and how to avoid common mistakes.