Administrative Memos

200704

FROM: Theodore O. Will, Chief Executive Officer
DATE: Jun 11, 2007
SUBJECT: IPRO Review of The New Hospital Discharge Appeals for The Medicare Beneficiary - Effective July 2, 2007
IPRO CONTACTS:

Alice Vallar, Senior Director, Medicare/Federal Health Care Assessment, extension 423; Fran Gordon, Assistant Director, Medicare/Federal Health Care Assessment, extension 423

As you may already be aware, effective Monday, July 2, 2007, a new appeals process is being established in accordance with the Centers for Medicare & Medicaid Services (CMS) final rule, CMS-4105-F: Notification of Hospital Discharge Appeal Rights published on November 27, 2006. (For further information, please refer to CMS-4105-F Notification of Hospital Discharge Appeal Rights Final Rule PDF, 174 KB )

The new Discharge Appeal process requires that the Medicare Beneficiary or his/her representative contact IPRO to request an appeal. IPRO will now receive these appeals seven (7) days a week (including weekends and holidays). IPRO must then contact the Hospital in order to request medical records and any other required information. IPRO will contact hospitals seven (7) days a week (including weekends and holidays) between the hours of 8:30 AM to 4:30 PM. The regulation requires that the requested information be provided to IPRO no later than noon of the day following IPRO's request.

To facilitate this appeal process, IPRO is requesting expanded contact information for your organization. Please complete the Fax Back Form and return it to the attention of Karen Sharpe no later than June 22, 2007.

IPRO

1979 Marcus Avenue

Lake Success, N.Y. 11042-1002

IPRO Fax: 516-326-6176

Should you have any questions or require additional information, please do not hesitate to contact Alice Vallar, Senior Director, Medicare/Federal Health Care Assessment, extension 423 or Fran Gordon, Assistant Director, Medicare/Federal Health Care Assessment, extension 423.