Patients & Visitors

If you think you are leaving too soon

Ask a Medical Center representative for a written notice of explanation immediately, if you have not already received one. This notice is called a “Notice of Noncoverage.” You must have this Notice of Noncoverage if you wish to exercise your right to request a review by the PRO. The Notice of Noncoverage will state that your doctor and/or the PRO agrees with the Medical Center’s decision that Medicare will no longer pay for your hospital care. If Managed Care covers you, the Notice will come from your insurance company. If the Medical Center and your doctor agree, the PRO does not review your case before a Notice of Noncoverage is issued. The PRO will respond to your request for a review of your Notice of Noncoverage and seek your opinion. If you request the review by noon of the first working day after you receive the Notice of Noncoverage, you cannot be made to pay for your hospital care until the PRO makes its decision. If the Medical Center and your doctor disagree, the Medical Center may request that the PRO review your case. If it does make such a request, the Medical Center is required to send you a notice to that effect. In this situation, the PRO must agree with the Medical Center or the Medical Center cannot issue a Notice of Non-coverage. You may request that the PRO reconsider your case after you receive a Notice of Noncoverage but since the PRO has already reviewed your case once, you may have to pay for at least one day of the hospital care before the PRO completes this reconsideration.

If you do not request a review, the Medical Center may bill you for all the costs of your stay beginning with the third day after you receive the Notice of Non-coverage. The Medical Center, however, cannot charge you for care unless it provides you with a Notice of Noncoverage.