Independent Contractor Case Summary

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The Administrative Contractor, Benefit Administrators (“contractor”), initially allowed payment for those services. However, on October 31, 2012 Healthcare formerly Connolly Healthcare, a Recovery Contractor (“RC”), notified the Appellant that the services were not reasonable and necessary on October 31, 2012. The Contractor then notified the Appellant of an overpayment on November 14, 2012. On June 6, 2013, the contractor denied the Appellant’s request for a redetermination. The Appellant submitted a request for reconsideration. The Independent Contractor (“QIC”), Services, reviewed the Appellant’s claim and issued an unfavorable reconsideration decision on August 9, 2013. The QIC held the Appellant responsible for payment of

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