[3517] C2C QIC Appeal Demo Phone Discussion & Reopening Process
Medicare Providers: an overview of the PAE Telephone Discussion process as well as the reopening
process.
Presentation Info:
TAHC&H Virtual Event | Spring Conference | Recorded for On-Demand Access
Presentation Date | May 12, 2021
Education-Training Credits:
TX HCSSA Administrator/Alternate Continuing Education
1.0 Clock Hr(s)
CE Approval Statements:
· This program meets continuing education requirements
for Administrators and Alternates under Texas HCSSA licensing regulations.
HCSSA Topic(s) Addressed:
§558.259[d][4]agency responsibilities
§558.260[a][3]basic principles of management in a licensed health-related setting
§558.260[a][7]financial management
Program Description: CMS uses Telephone Discussions to give Part A East providers the opportunity to provide
verbal testimony through a phone discussion that could possibly result in a favorable outcome. After success with the discussions in DME, in April 2019,
CMS expanded the appeals Demonstration to Part A East. C2C will provide an overview of the PAE Telephone Discussion process as well as the reopening
process which allows potential cases to be remanded back from the ALJ and reopened at the reconsideration level.
TAHC&H Faculty/Presenter(s): Emily Barnes, Education & Outreach Specialist,C2C Innovative Solutions, Inc.,
the Part A East Qualified Independent Contractor (QIC) and Charles Canaan, Palmetto GBA.
About the Presenter(s): Emily Barnes received a Bachelor’s degree in Health Services Administration in 2002,
followed by a Masters’ degree and Specialist degree in Education Leadership. Prior to joining C2C Innovative Solutions, Inc. in 2015, Emily worked in the public
sector for 14 years, including an administrative roll for 5 of those years. Emily currently meets with CMS, OMHA, and the MACs regularly to present updates and
information regarding the Part A East Appeals Demonstration. For the last six years, Mrs. Barnes has been the Education & Outreach Specialist, sharing the
Telephone Discussion Demonstration at numerous conferences, state association meetings, national presentations and Jurisdiction Council advisory meetings.
Mrs. Barnes brings a wealth of information and over 15 years’ experience to C2C Innovative Solutions, Inc.
About the Presenter(s): Charles Canaan has over 30 years of diverse nursing experience in a variety of healthcare
settings, to include inpatient, outpatient, home and organizational settings. His education includes a Bachelor of Science Degree in Nursing from Old Dominion
University in Norfolk, Virginia and a Master of Public Health Degree in Health Promotion and Education from the University of South Carolina and a Coding for
Health Care Professionals Certificate from Trident technical College. He currently provides education and consultation to Medicare providers with learning needs.
[3517] C2C QIC Appeal Demo Phone Discussion & Reopening Process