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A Quality Improvement Organization (QIO), formerly known as Peer Review Organization, is a group of practicing doctors and other health care experts paid by the federal government to check and improve the care given to Medicare patients. QIOs must review your complaints about the quality of care you get and appeals for care in inpatient hospitals, hospital outpatient care departments, hospital emergency rooms, skilled nursing facilities (SNFs), home health agencies (HHAs), Private Fee-for-Service (PFFs) plans, and ambulatory surgical centers. QIOs also contract with Medicare to conduct appeals. For example, QIOs review expedited appeals when a Medicare private health plan (Part C) denies coverage or terminates services from a hospital, home health agency, SNF, or comprehensive outpatient rehabilitation facility (CORF), or Original Medicare denies coverage of home health care, SNF care, hospice care or CORF care.

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