If your appeal is denied, you may be forced topay out of pocket.
It is not based on an individual’s health status or their physical readiness to leave.
Based on the codes assigned to you, the payer is obligated to pay that amount and no more.
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Unless you pay cash or get authorization for an extension, the hospital will need to send you home.
Or, maybe you are just lonely and appreciate the attention you get in the hospital.
The truth is, in most cases, these are not good enough reasons to stay.
The steps for an appeal will vary from hospital to hospital and from state to state.
There may be instances where the hospital will insist that an extension is unnecessary.
The hospital may have a genuine medical reason for this or be simply running short of beds.
Whatever the situation, you may be forced to fight the hospital administrator.
One way to do so is with the hospital’s “Safe Discharge” policy.
After that, you may be responsible if you decide to stay and the appeal is denied.
Centers for Medicare & Medicaid Services.Quality improvement organizations.
Centers for Medicare & Medicaid Services.Fast appeals.
McIlvennan CK, Eapen ZJ, Allen LA.Hospital readmissions reduction program.Circulation.
