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Livanta BFCC-QIO Program fax number
(844) 420-6671
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BFCC-QIO Program
Used for: Medicare beneficiary complaint submission and review requests (BFCC-QIO process), including care quality concerns and discharge reviews.
Fax destination details
- Department
- BFCC-QIO Program
- Purpose
- Medicare beneficiary complaint submission and review requests (BFCC-QIO process), including care quality concerns and discharge reviews.
- Form
- CMS-10287 — CMS-10287 Beneficiary Complaint Form
- Address
- 10820 Guilford Road, Suite 202, Annapolis Junction, MD 20701-1105
- Voice phone
- 888-524-9900
- Website
- Visit organization website
Before you send
- Confirm that this exact department handles your document or request.
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- Include a cover sheet and any case, member, claim, or form reference required.
- Keep the delivery confirmation with your submission records.
Fill CMS-10287 with patient/resident name, facility name and address, dates, and a detailed description of the concern; submit by fax to 844-420-6671 or mail to Livanta BFCC-QIO, 10820 Guilford Road, Suite 202, Annapolis Junction, MD 20701-1105; you may also contact the BFCC-QIO for assistance.
Official form instructions are published as a downloadable file on the organization's website.
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