As a Medicare beneficiary and/or their family member/caregiver, you can file an appeal with your regional Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) if you do not agree with a healthcare provider’s decision to send you/your loved one home from the hospital, or if you do not agree with their decision to discontinue services.
After you call your BFCC-QIO to start your appeal, they will contact your healthcare provider to obtain your medical record. Once the record is received, a physician reviewer will review the record and decide if you are ready to be discharged. Your BFCC-QIO will call you and send you a letter to inform you of your appeal decision. The regional BFCC-QIO can also refer your information to the Beneficiary Care Management Program (BCMP) for assistance with short- and longer-term (up to 30 days) care management of your chronic conditions.
Medicare beneficiaries and/or their families/caregivers can also contact their regional BFCC-QIO if they need to discuss the quality of care received, file a formal or verbal quality of care complaint, or discuss their Medicare rights. If there are concerns about the quality of care received from a Medicare provider or healthcare facility, beneficiaries and/or their families/caregivers can file a formal complaint.
For more information about the BCMP, click here.