MM13918: Billing Instructions: Expedited Determinations Based on Medicare Change of Status Notifications
This new Article comprises Subregulatory Guidance for when patients are eligible to appeal a hospital status change, Quality Improvement Organization (QIO) role in the appeals process and claims processing based on QIO appeal decision. MLN Matters (MM) Articles are based on information contained within Change Requests (CRs). In this case, this article is based on content within CR13918 that is posted on the CMS website at https://www.cms.gov/files/document/r13026cp.pdf.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 06, 2025
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.