What Is a BFCC-QIO in Medicare?
Short answer
A Beneficiary and Family Centered Care Quality Improvement Organization is a Medicare contractor with roles that include specified fast appeals and review of certain quality-of-care concerns.
Coverage And Action
The BFCC-QIO named in a Medicare notice can review qualifying service-termination decisions. BFCC-QIOs also handle specified beneficiary quality complaints.
Not Automatic
A BFCC-QIO is not the universal first appeal level for every Medicare claim or Medicare Advantage denial. Follow the notice for the decision involved.
Practical Example
When covered SNF services are ending and the beneficiary believes termination is premature, the termination notice can direct the beneficiary to the BFCC-QIO fast-appeal process.
Questions to verify
- Does my notice name a BFCC-QIO?
- Is this a fast termination appeal or a quality complaint?
- What is the filing deadline?