FFS ED Notices
HHAs, SNFs, Hospices, and CORFs are required to provide a Notice of Medicare Non-Coverage (NOMNC) to beneficiaries to alert them that Medicare covered item(s) and/or service(s) are ending and give beneficiaries the opportunity to request an expedited determination from a QIO. A Detailed Notice is given when the QIO review is requested in order to provide more explanation on why coverage is ending.
Download FFS Expedited Determination Notices and Instructions
NOTE: NEW GUIDANCE IS AVAILABLE FOR THE FFS EXPEDITED DETERMINATION PROCESS. THIS GUIDANCE IS EFFECTIVE AUGUST 26, 2013. FOR DETAILS, SEE THE "RELATED LINK" BELOW, TITLED, "TRANSMITTAL 2711 - EXPEDITED DET (EFF AUG 26, 2013)".
To download the FFS Expedited Determination Notices and Instructions, please click on the appropriate link below.
- UPDATED - Notice of Medicare Non-Coverage (NOMNC) - English and Spanish [ZIP, 68KB]
- UPDATED - Instructions for Notice of Medicare Non-Coverage [PDF, 52KB]
- UPDATED - Detailed Explanation of Non-Coverage (DENC) - English and Spanish [ZIP, 87KB]
- UPDATED - Instructions for Detailed Explanation of Non-Coverage [PDF, 26KB]
- Page last Modified: 11/20/2013 2:03 PM
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