{"key":"bfcc_qio","name":"BFCC-QIO Review (Discharge Appeal / Quality-of-Care Complaint)","regulation_cite":"42 CFR 405.1206; 42 CFR 476.120-476.170","selection_kind":"uphold_or_overturn","assignment_kind":"regulator_assignment","deadlines":{"unit":"calendar_day","determination_days":1,"attest_days":null,"eligibility_days":null},"required_credentials":["MD","DO"],"permitted_factors":[{"key":"medical_necessity","label":"Medical necessity / Medicare coverage policy for continued inpatient care"},{"key":"evidence_based_standard_of_care","label":"Evidence-based standards of care (or available norms/best practices)"},{"key":"hospital_or_provider_record","label":"The hospital's or provider's medical and other records"}],"fee_rule":{"kind":"not_applicable","single_range":null,"batched_range":null,"fixed_amount_usd":null,"dismissed_amount_usd":null,"paid_by":null}}