2024 Evidence of Coverage for UnitedHealthcare® Group Medicare Advantage PEBB Balance (PPO) Chapter 9: What to do if you have a problem or complaint (coverage decisions, appeals, complaints) 217 - Your right to receive Medicare-covered services during and after your hospital stay, as ordered by your doctor. This includes the right to know what these services are, who will pay for them, and where you can get them. - Your right to be involved in any decisions about your hospital stay. - Where to report any concerns you have about the quality of your hospital care. - Your right to request an immediate review of the decision to discharge you if you think you are being discharged from the hospital too soon. This is a formal, legal way to ask for a delay in your discharge date so that we will cover your hospital care for a longer time. 2. You will be asked to sign the written notice to show that you received it and understand your rights. - You or someone who is acting on your behalf will be asked to sign the notice. - Signing the notice shows only that you have received the information about your rights. The notice does not give your discharge date. Signing the notice does not mean you are agreeing on a discharge date. 3. Keep your copy of the notice handy so you will have the information about making an appeal (or reporting a concern about quality of care) if you need it. - If you sign the notice more than two days before your discharge date, you will get another copy before you are scheduled to be discharged. - To look at a copy of this notice in advance, you can call Customer Service or 1-800 MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048. You can also see the notice online at www.cms.gov/Medicare/Medicare- General-Information/BNI/HospitalDischargeAppealNotices.html. Section 7.2 Step-by-step: How to make a Level 1 appeal to change your hospital discharge date If you want to ask for your inpatient hospital services to be covered by us for a longer time, you will need to use the appeals process to make this request. Before you start, understand what you need to do and what the deadlines are: · Follow the process. · Meet the deadlines. · Ask for help if you need it. If you have questions or need help at any time, please call Customer Service. Or, call your State Health Insurance Assistance Program, a government organization that provides personalized assistance.