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If an initial dedication involved a call concerning the medical necessity of an merchandise or service, the QIC’s reconsideration should involve consideration by a panel of physicians or applicable healthcare professionals, and must be primarily based on scientific experience, the affected person’s medical information, and medical, technical, and scientific proof on document. The place the claim includes physician providers, the reviewing professional have to be a physician. Nevertheless, the doctor reviewer needn’t be in the same specialty because the physician whose claims have been denied.