Last Modified: 8/3/2017 Location: FL, PR, USVI Business: Part A, Part B
Payment Dispute Resolution Contractor (PDRC) -- Medicare Advantage
The Centers for Medicare & Medicaid Services (CMS) contracts with C2C Innovative Solutions, Inc. (C2C) to serve as the national independent entity to resolve payment disputes between Medicare Advantage (MA) organizations, Private Fee for Service (PFFS) plans, and deemed and non-contracted providers. C2C brings vast experience in adjudicating Medicare appeals on behalf of CMS. It is important to note that disputes by a Medicare Advantage contracted provider are not handled under this payment dispute resolution process, nor are beneficiary and provider appeals of coverage determination.
To file a request for an independent payment dispute decision (PDD), please visit the C2C Innovative Solutions, Inc. website at https://www.tmf.org/C2CSolutionsInc/tabid/1284/Default.aspx .
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