Quality Review (QR) uses the SSA-93 Quality Review Feedback Report to notify the field office (FO), processing center (PC), the Office of the Regional Commissioner (ORC), and the Associate Commissioner (AC) of the Office of Central Operations (OCO) (for PC 7 and 8) of findings that identify payment errors and informational items which require corrective action but do not affect the sample payment.

The purpose of the rebuttal process is to resolve case-related disagreements between QR and operating components. This process ensures that issues are resolved systematically and objectively and that affected beneficiaries receive a correct benefit payment. Informal communications between QR and the operating components are encouraged to expedite resolution.

The FO or PC may rebut a cited deficiency only if it meets the criteria for a rebuttable issue outlined in QR 04410.040C in this section.

Use the SSA-93 Quality Review website to submit a rebuttal to the reviewing QR field site within 45 days of the date QR transmitted the SSA-93.

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  Select “Rebuttal Request Sent to QR” in the “Respond to SSA-93 Review” area of the detail screen on the SSA-93 website,

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  use the Comments box to explain the issue, and

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  scan all supporting material into the electronic folder and clearly indicate the location in the Comments box.

The SSA-93 website notifies the ORC/AC of OCO of the rebuttal request once submitted.

Delay corrective action only on contested deficiencies pending final resolution. Correct all non-disputed deficiencies cited on the case.

Only dollar deficiencies that affect the sample period’s payment cited by QR are subject to the formal rebuttal process.

QR identifies non-payment and informational items on the SSA-93. Informally resolve questions related to non-payment and informational items via email or telephone contact. The FO or PC should reconcile any item where a policy misinterpretation is involved. If necessary, QR revises the quality review database to reflect an informal resolution. The FO or PC must document the case when the decision is that corrective action is unnecessary or one that differs from the original QR findings.

Deficiencies cited by QR not rebutted by the FO or PC under the rebuttal process described in this section are:

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  Non-payment deficiencies,

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  evidentiary deficiencies, and

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  all informational items.

If the FO or PC disagrees with a deficiency, follow the rebuttal process described in this section. Resolution of a rebuttal is possible at any level in this process. When all SSA components involved reach an agreement, the rebuttal is resolved. Encourage informal communications via telephone or email to expedite problem resolution. The FO or PC and QR record the rebuttal decision on the SSA-93 Quality Review website.

If the PC or FO disagrees with a rebuttable deficiency finding, the PC or FO contacts the reviewing QR office within 45 calendar days of the date of transmission of the SSA-93 feedback report to the SSA-93 Quality Review website.

If attempts to resolve the issue informally fail, the PC feedback coordinator or FO should use the SSA-93 website to submit a formal rebuttal as described in QR 04410.040B in this section.

To prevent the PC from initiating corrective action on FO caused errors in the rebuttal process, the FO should

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  contact the PC feedback coordinator via telephone or email;

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  inform the PC of their disagreement with QR's findings; and

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  instruct the PC not to take action on the protested deficiency pending a resolution.

The SSA-93 website will automatically notify the appropriate ORC/AC of OCO of the first level rebuttal once submitted.

You can find contact information for QR Field sites (AIPQBs) at OQR Field Sites.

If the FO or PC agrees with the AIPQB rebuttal decision, the FO or PC annotates the SSA-93 Quality Review website after all corrections are complete.

If the FO or PC disagrees with the AIPQB rebuttal decision, the FO or PC must update the SSA-93 website within 15 days to request a second level rebuttal. The rationale for the second level rebuttal request is required in the Comments box. The SSA-93 website sends an automated email to the RO with the rebuttal request and comments.

After resolution of all rebuttal actions, the FO or PC takes corrective action within 90 days and updates the SSA-93 Quality Review website. The ORC/AC of OCO is responsible for ensuring that corrective actions are completed.

Refer to the chart for ORC/AC of OCO and PC addresses: