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Definitions:

Administrative law judge (ALJ) decision: The decision made by the ALJ if an ALJ appeal occurs

Case number: The number assigned by the Medicare Appeal System to the Level 2 or Level 3 appeal

Independent review entity (IRE) request received date: The date the reconsideration was received at the IRE

IRE appeal priority: The priority determined by the IRE, which determines appeal processing timeframes (i.e., expedited, pre-service Part B drug, pre-service, retrospective)

IRE corrected recon receipt date: The date, as determined by the IRE, that the request for a reconsideration was received by the plan (Note: No date will appear if the IRE verifies the plan reported recon receipt date)

IRE recon decision: The decision made by the IRE on reconsideration at Level 2

IRE reopen decision: The decision made by the IRE on reopening if a reopening occurs at the IRE

Last decision date: The date of the most recent decision made by the IRE or ALJ

Plan extension (Y/N): This indicates whether the plan allowed an extension of the reconsideration timeframe, as reported to the IRE on the Reconsideration Background Data form.

Plan reported recon receipt date: The date reported by the plan on the Reconsideration Background Data form that the plan received the request for a reconsideration

Plan timely: Timeliness is based on the number of days between the IRE request received date and plan reported recon receipt date columns (Note: If there is a date in the IRE corrected recon receipt date column, then timeliness is based on the number of days between the IRE request received date and the IRE corrected recon receipt date columns)

Qualified independent contractor (QIC) appeal deadline: The deadline date for the QIC appeal