expedited appeal connection 1-2.pub - FMQAI

Obtaining The Notices - www.cms.gov/bniBoth the FFS and Medicare Advantage ED notices can be found at the Beneficiary Notices Initiative(BNI) web site. Mandatory use of the latest FFS forms began on November 1, 2008. FMQAI can nolonger accept expired forms. They will be returned to your facility as an invalid notice.On the FFS web page, you will find the generic notice both in Word and pdf form. There is also a noticethat is written in Spanish. The detailed notice is also offered in these formats. There are instructions forboth forms on the site. The expiration date on this form is 7/31/2011.On the MA web page, the generic notice and detailed notice are only offered in pdf form. There areinstructions for both forms on the site. The expiration date on this form is 8/31/2010.Contact Information FormFMQAI has a contact information form on the FMQAI websitelocated at http://www.fmqai.com/Healthcare-Initiatives-RT-ED.aspx.The form allows your facility to designate contacts so that we may knowwho to contact after hours and on weekends as well as your primarycontact. This allows both FMQAI and your facility to better completethe appeal process in a timely manner. If you have not filled out thecontact form for your facility, please visit our web site. Fax thecompleted form to Cheryl Cook at 813-354-0737.