If you or a loved one are covered by Medicare and ever hospitalized in a medical facility, behavioral health center, or rehab care facility, here is some important information that we hope you'll never need to use.
If a facility is discharging you or your loved one before you think they're ready to go home, that my be considered an "unsafe discharge".
You can file an appeal to delay or stop the unsafe discharge with KEPRO, Medicare's Quality Improvement Organization.
Appealing a discharge through KEPRO allows KEPRO to review the patient's medical records and determine if the discharge is appropriate or if the patient needs to stay in the facility for further treatment until a safe discharge can be accomplished.
Here are some helpful tips to assist you with the appeal process:
888-315-0636 is the toll free phone number for Region 6, which is the region Texas is located
The patient must be covered through Medicare in order for KEPRO to get involved
Appeals can be filed via phone by anyone who can provide information about the details of why the discharge is unsafe
For the appeal, you'll need the facility name, patient's name and date of birth. Be prepared to share details about the patient's condition and why you believe the discharge is unsafe for the patient.
Appeals must be filed before the patient is actually discharged. KEPRO cannot help after a patient is discharged.
You'll be given a case ID number for the KEPRO appeal.
Once an appeal is made, KEPRO will contact the facility to request the patient's medical records. A medical professional with KEPRO will reveiw the records, along with details you've provided to determine if the appeal will be approved or closed.
TIMING is critical. Depending on the time of day when you request the appeal, it may take several hours or the next day for KEPRO to contact the facility to alert them about the appeal. KEPRO will likely advise you to contact the facility and give them the case ID number so that they will know the discharge is being appealed.
The status of your appeal can be checked through KEPRO's website.
We hope you'll never need to utilize this information about appealing a discharge, because we know the frustration and stress that any illness or health condition creates. Most people don't realize that KEPRO exists to help with this process, but now you do!
Share this article with anyone you know who is on Medicare and may need it for a future hospitalization.
Stay well and safe!