Medicare patients who believe they are being discharged from the hospital too soon can use the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) to request an expedited review **FROM THE PHYSICIAN, NOT THE CASE MANAGER** that temporarily maintains coverage while the decision is made. The discharge process will be paused for this process to play out.

To utilize this right, patients and their families must follow a strict sequence:
1. Obtain the Important Message from Medicare (IM) or Hospital-Issued Notice of Non-Coverage (HINN) from the hospital.

2. Request an appeal from the BFCC-QIO by calling the number listed on the hospital’s discharge notice no later than midnight on the day of the scheduled discharge. If you miss the deadline, you'll likely be on the hook for whatever horse shit number the hospital charges you.

3. Once the appeal is filed, the hospital must provide a Detailed Notice of Discharge (DND) by noon the day after the hospital is notified. This document explains the medical and coverage reasons for the discharge.

4. A doctor not affiliated with the hospital will review your medical records to determine if the discharge is medically necessary. The BFCC-QIO must issue a decision within one day of receiving the necessary information.

5. If the BFCC-QIO agrees with the hospital, you have until noon of the following day to request a reconsideration. The BFCC-QIO has 72 hours (or up to 14 days with an extension) to issue this final determination.

For assistance beyond the appeal, such as clarifying discharge plans without initiating a formal appeal, patients can request Immediate Advocacy Discharge Assistance (IADA) from the BFCC-QIO, though this service can't help you with discharge dates or involve itself in clinical reviews.

More info here: https://www.cms.gov/medicare/quality/quality-improvement-organizations/family-centered-care

Like with all things in our society, if you don't know your rights, you don't have any.

#Medicare #patientrights #medicaldebt #patientadvocacy

Health Insurance Scam? Woman Pays More WITH Coverage Than Without for Care

Why does insurance cost more than cash? This shocking story breaks it down. A viral story reveals how U.S. health insurance forces patients to pay more, not less.

Medical debt is often framed as a modern problem, but its origins stretch back through the evolution of healthcare payment systems. 🏥💸

From direct payment to insurance-based models, each shift reshaped financial responsibility and patient burden.

#MedicalDebt #Healthcare #History #Brewminate

https://brewminate.com/history-medical-debt-healthcare-payment-systems/

Alright, this is absolutely first world problems, but holy mother of healthcare, am I furious.

So, I saw a doctor in the #Baylor system (who have purchased most medical practices in the area), a few weeks ago. I paid the doctor at the time of the visit. ($165 after insurance). I knew there was a facility fee, but refused to pay it, because it's egregious.

I got an email this morning from Baylor saying I owed another $300 for facility fees. (I was waiting for the bill, so I could talk to someone about it.)

So I called and said "Hey, this charge is unreasonable, and well outside usual and customary fees."

And their response, as Bob is my witless was, "Our fees are defensible." Which means they had lawyers sitting up figuring out to the last penny what they think they can get away with.

Those lawyers never met me.

#medicalDebt #USHeathcare #profiteering

URGENT #MutualAid #MedicalDebt

If you can, please donate something to author Piper J. Drake's GFM for medical expenses. If you are in the U.S., you know how ruinous this is. If you are not, please read the post. Either way, give what you can--no amount is too small--and share the link.

Remember: tip ZERO--GFM charges fees from the donations, you don't need to give them more money at the expense of people already struggling to raise enough money to pay their bills.

https://www.gofundme.com/f/help-author-fight-cancer-so-she-can-finish-her-book