Your appeal rights if you were asked to leave the hospital and you missed the deadline for asking for an immediate review of your case (Original Medicare)

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Last Update: November 02, 2011

If you miss the deadline for asking for an immediate (expedited) review of your case by the Quality Improvement Organization (QIO), you can still ask that it review your case. However, the hospital will be allowed to charge you for care you receive after the date the hospital planned to discharge you. If you win the appeal, the hospital must reimburse you if you have already paid. The timeline for taking action depends on whether you are still in the hospital or not.

  • If you are still in the hospital, you can request an expedited QIO review at any time during your hospital stay—even after the deadline for an immediate review has passed. The QIO has two calendar days after receiving all requested information to send you its written decision.
  • If you stayed in the hospital past the date the hospital originally wanted to discharge you, but have since left it, you have 30 days from the original discharge date to request a review. The QIO must send you its written decision within 30 days after receiving all requested information.

    For information on how to ask for an expedited review, click on "What should I do if I feel I am being asked to leave the hospital too soon?" in the GO TO box

     


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GO TO
Your appeal rights if you feel you are being asked to leave the hospital too soon

Your appeal rights if you were asked to leave the hospital and you missed the deadline for asking for an immediate review of your case (Medicare Advantage)

Timeline for Medicare appeals

How much will Medicare pay if I am in the hospital?

Medicare coverage of inpatient hospital care

 
LINKS
American Hospital Association: Quality and Patient Safety

Medicare Publication - Your Rights and Protections (PDF)

MyMedicare.gov: Access your Medicare information

Directory of Quality Improvement Organizations by State

The National Committee for Quality Assurance (NCQA)

State Health Insurance Assistance Program (SHIP) Directory

 
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