Medicare will continue to cover your hospital stay as long as medically necessary (except for applicable coinsurance or deductibles) if your plan previously authorized coverage of the inpatient admission, or the inpatient admission was for emergency or urgently needed care. If the BFCC-QIO decides that you're being discharged too soon: The BFCC-QIO will decide if you're ready to be discharged within one day of getting the requested information. The BFCC-QIO will look at your medical information provided by the hospital and will also ask you for your opinion. You can also ask your plan for copies of any of the materials that your plan sent to the BFCC-QIO about your hospital discharge. How the applicable coverage rule or policy applies to your specific situation.A description of the applicable Medicare coverage rule or policy, including information on how you can get a copy of the policy.Why your services are no longer reasonable and necessary or are no longer covered.Once your plan and the hospital are notified by the BFCC-QIO, your plan or the hospital will provide you a "Detailed Notice of Discharge." Your plan or the hospital will provide this notice by noon of the day after the BFCC-QIO notifies the hospital. When the BFCC-QIO gets your request within the fast appeal time frame, it will notify the plan and the hospital. What will happen during the BFCC-QIO's review? If you're in a Medicare Advantage Plan, you can ask your plan for an appeal, but different rules apply. If you miss the deadline for a fast appeal, you can still ask the BFCC-QIO to review your case, but different rules and time frames apply and you might be responsible for the cost of the hospital stay past the original day the hospital tries to discharge you. You won't have to pay for your stay (except for applicable coinsurance or deductibles). If you ask for your appeal within this time frame, you can stay in the hospital while you wait to get the BFCC-QIO's decision. You must ask for a fast appeal no later than the day you're scheduled to be discharged from the hospital. Follow the directions on the IM to request a fast appeal if you think your Medicare-covered hospital services are ending too soon. You may have the right to ask the BFCC-QIO for a fast appeal. If the hospital gives you the IM more than 2 days before your discharge day, it must give you a copy of your original, signed IM or provide you with a new one (that you must sign) before you're discharged.
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