Appealing Hospital Discharges

If you believe you’re being discharged too soon, you have the right to file an appeal. Upon admission, you should have received an “Important Message from Medicare” explaining this right. If your stay exceeds three days, you’ll receive another copy 4 hours to 2 days before discharge.

This notice outlines how to file a fast (expedited) appeal with the Quality Improvement Organization (QIO). To appeal, take action by midnight on the day of discharge. The hospital will then provide a Detailed Notice of Discharge, explaining why Medicare coverage is ending. The QIO typically responds within 24 hours.

If the QIO agrees with the hospital to discharge, you can appeal to higher levels. Be aware that staying in the hospital after the QIO decision may leave you responsible for costs unless a later appeal overturns it.

Tips for success:

• Meet all appeal deadlines.
• Keep detailed notes and copies of documents.
• Include a letter from your doctor explaining why additional care is necessary.
• Contact your State Health Insurance Assistance Program (SHIP) for help.

Act quickly to protect your rights and ensure thorough review of your case.