When you are admitted to a hospital, you have the right to get hospital care that is necessary to diagnose and treat your illness or injury. The day you leave the hospital (your discharge date) is based on when your hospital stay is no longer medically necessary.
If you feel that you are being discharged too soon, call the Ohio KePRO Beneficiary Helpline at 1-800-589-7337 immediately – before you leave the hospital – and ask for a fast-track review. You should have a sheet called “An Important Message From Medicare About Your Rights” in hand when you call. Patients are given this sheet upon admission and then again before they leave the hospital.
Once you have submitted your request for a fast-track review, Ohio KePRO will ask the hospital to write a Detailed Notice of Discharge. The hospital will give Ohio KePRO and you a copy of the notice. Ohio KePRO will take one day to review your case.
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If Ohio KePRO agrees with the hospital’s decision You will be responsible for paying the hospital charges beginning noon of the day after Ohio KePRO gives you its decision. You are not responsible for payment during the review process if you request the review in a timely manner.
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If Ohio KePRO agrees with you Medicare will continue to cover services as long as they are medically necessary.
Appeal for a Review of Termination of Other Healthcare Services
If medical services outside of the hospital are being discontinued, you will receive a notice at least two days or visits before payment is scheduled to end. This is called a “Notice of Medicare Provider Non-Coverage.” This form is also available in Spanish: “Spanish Notice of Medicare Provider Non-Coverage.” If you feel that you are being discharged too soon, call the Ohio KePRO Beneficiary Helpline at 1-800-589-7337 immediately – before your coverage ends – and ask for a fast-track review. Please have your “Notice of Medicare Provider Non-Coverage” in hand when you call.Once you have submitted your request for a fast-track review, Ohio KePRO will ask the provider to write a Detailed Notice of Discharge. The provider will give Ohio KePRO and you a copy of the notice. Ohio KePRO will review your case within 24-72 hours.
- If Ohio KePRO agrees with the provider’s decision You will be responsible for paying the provider charges beginning noon of the day after Ohio KePRO gives you its decision. You are not responsible for payment during the review process if you request the review in a timely manner.
- If Ohio KePRO agrees with you Medicare will continue to cover services as long as they are medically necessary.
