Tuesday, April 29, 2014

Medicare Rights

As a hospital inpatient, you have the right to:
  • Receive Medicare covered services. This includes medically necessary hospital services and services you may need after you are discharged, of ordered by your doctor. You have a right to know about these services, who will pay for them and where you can get them.
  • Be involved in any decisions about your hospital stay, and know who will pay for it.
Report any concerns you have about the quality of care you receive to the Quality Improvement Organization
(QIO) at Masspro at 1-800-252-5533 (TTY 1-800-439-2370.)

Your Medicare discharge rights: During your hospital stay, the hospital staff will be working with you to prepare you for safe discharge and arrange for services you may need after you leave the hospital. When you no longer need inpatient hospital care,
your doctor or the hospital staff will inform you of your planned discharge date.

If you think you are being discharged too soon:
  • You can talk to the hospital staff, your doctor and your managed care plan about your concerns.
  • You also have the right to an appeal, that is , a review of your case by a Quality Improvement Organization (QIO). The QIO is an outside reviewer hired by Medicare to look at your case to decide whether you are ready to leave the hospital. To appeal, you must contact the QIO no later than your planned discharge date and before you leave the hospital.
  • If you do not appeal, but decide to stay in the hospital past your planned discharge date, you may have to pay for any services you receive after that date.
To file an appeal or report any concerns you have about the quality of care you receive
Masspro 1-800-252-5533 (TTY 1-800-439-2390)
between 8:30 AM—5:00 PM
(If you call this helpline outside of normal business hours, be sure to listen carefully to the after-hours helpline message and follow the instructions.)
(published by the Department of Health & Human Services Centers for Medicare & Medicaid Services)

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