Final answer:
A Qualified Independent Contractor (QIC) conducts the second level of Medicare appeals, which involves an independent review of the initial denial of Medicare coverage or payment.
Step-by-step explanation:
A Qualified Independent Contractor (QIC) conducts the second level of Medicare appeals. If a Medicare claim is denied at the initial determination stage, a beneficiary or provider may appeal to a QIC for reconsideration. The QIC's role is to provide an independent review of the initial denial of Medicare coverage or payment. During this process, the QIC examines all of the documentation and arguments provided, as well as any additional evidence submitted. The QIC then issues a written decision that affirms, modifies, or reverses the initial denial. If the QIC decision is still not satisfactory, the case can be escalated to the next levels of appeal, including Administrative Law Judge hearings, the Medicare Appeals Council, and, potentially, federal court.