Getting discharged, services ending, or moved to observation status? Here's what to do in the next few hours.

Notice of Medicare Non-Coverage (NOMNC)

Says a covered SNF, home health, hospice, or CORF service is ending on a specific date. Request the fast appeal by the date and time on the form — no later than noon of the day before your services end.

What to say on the call

1. Say you want to file a fast appeal (expedited determination) of a coverage-ending decision.
2. Give the QIO the date services are set to end, from the NOMNC.
3. Ask them to request the detailed explanation from the facility on your behalf.

Next: The QIO decides within 72 hours of having what it needs. The facility must send a detailed explanation of why coverage is ending.

Important Message from Medicare (IM)

Given at hospital admission and again near discharge; explains the right to appeal a discharge. Request review no later than the day of discharge, before you leave the hospital.

What to say on the call

1. Say you want to file a fast appeal (expedited determination) of a hospital discharge decision.
2. Give the QIO the planned discharge date from the Important Message.
3. Ask them to request the detailed notice from the hospital on your behalf.

Next: The QIO decides within 1 calendar day of having what it needs. The hospital must send a detailed notice explaining the discharge decision.

Medicare Change of Status Notice (MCSN)

Says the hospital reclassified the patient from inpatient to observation, and gives the right to a fast QIO appeal. Request review before you're released from the hospital.

What to say on the call

1. Say: "I am requesting an expedited appeal of the change in my status under 42 CFR 405.1211."
2. If your parent never got an MCSN, say: "Please give me the Medicare Change of Status Notice."
3. Give the QIO the hospital's name and the date of the status change.

Next: The hospital must send your records to the QIO by noon the next calendar day. The QIO decides within 1 calendar day of receiving them. Winning restores the days as inpatient — which can qualify your parent for nursing-home coverage afterward.