Federal agency ยท Centers for Medicare & Medicaid Services
Beneficiary and Family Centered Care Quality Improvement Organizations: find yours
The Medicare contractors that handle fast appeals when hospital or other care is ending too soon, and complaints about the quality of care. Each state is assigned to one of two organizations.
Know before you go
The page says these reviewers help with appeals when you think Medicare-covered services (for example a hospital stay) are ending too soon, and with quality-of-care complaints. They do not handle appeals of a payment or coverage denial for a claim; the Medicare appeals page covers those. Your region is found on the region map linked from the page, and your discharge notice says how to ask for a fast appeal.
- Cost
- Not stated. The page lists no fee.
- Where
- Nationwide
- How to start
- Open the region map on the page to find the organization for your state, then call it. If you got a notice that your services are ending, follow the fast-appeal instructions on it.
- Have ready
- Your notice that services are ending; Your Medicare number; The name of the hospital or facility
Where this comes from
- Provider
- Centers for Medicare & Medicaid Services
- Source we read
- https://www.cms.gov/medicare/quality/quality-improvement-organizations/family-centered-care
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- Not displayed
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
California Department of Managed Health Care: Independent Medical Review
California's regulator for managed care plans reviews denials of medical services, emergency payment and experimental treatment through Independent Medical Review. One form starts either a review or a consumer complaint.
From California Department of Managed Health Care
- Program or service
Center for Medicare Advocacy self-help materials
Downloadable self-help toolkits for Medicare denials involving home health care, outpatient therapy and skilled nursing facility care, from a nonprofit law organization. The page describes materials, not a helpline.
From Center for Medicare Advocacy
- Program or service
Coverage Rights state-by-state appeal steps
A nonprofit website that gives each state's steps for appeal, external review and complaint when an insurer denies or delays a treatment, with a focus on medicines. No helpline or letters.
From Aimed Alliance