Termination of Service Appeals

You will receive a written discharge notice at least two days before your coverage of service ends. You have the right to appeal your healthcare provider's decision to terminate coverage from a nursing home, home health agency, hospice, or a comprehensive outpatient rehabilitation facility.

Should I appeal a healthcare decision?
You should appeal a healthcare decision if you disagree with it based on your medical condition, how you are feeling, or if you have a legitimate medical reason to continue receiving a medical service.

Who can request an appeal?
Any Medicare member or a designated representative (for example, family member, legal guardian, caregiver) can request an appeal.

How much does it cost to appeal?
There is no cost for filing an appeal. To request an appeal contact QSource toll-free at 800.261.1437. The TDD-hearing impaired number is 877.486.2048 Phones are answered seven days a week from 9:00 a.m. to 5 p.m., and translation services are available.

How do I file a termination of service appeal?

•	Call QSource if you believe your services should still be covered. You must request an appeal by noon the day before the notice states your Medicare coverage will end.
•	Once your request an appeal, QSource asks your Medicare health plan or provider to submit specific information. If all the necessary information has been provided, a decision on the appeal will be made by 5:00 p.m. the next day.

You cannot be sent home or billed for services until the review of your case has been completed.