More information on the revised notice process can be found at: http://www.cms.hhs.gov/BNI, click on “Hospital Discharge Appeal Notices”. FAQs have been posted at the “Resources” link. CBC has established an email address for providers to submit questions regarding the new hospital appeals process - weichardt_ODF@cms.hhs.gov
Hospitals provide Hospital-Issued Notices of Noncoverage (HINNs) to beneficiaries prior to admission, at admission, or at any point during an inpatient stay if the hospital determines that the care the beneficiary is receiving, or is about to receive, is not covered because it is:
- Not medically necessary;
- Not delivered in the most appropriate setting; or
- Is custodial in nature.
Click on the link "Hospital Discharge Appeal Notices" for notices used to inform beneficiaries of their right to request QIO review of discharge decisions on or after July 2, 2007.
Please note:
- HINN 11, which is used for noncovered items or services provided during an otherwise covered stay, and its instructions have not yet been incorporated into Chapter 30 of the Online Claims Processing Manual.
- HINN 12 should be used in association with the Hospital Discharge Appeal Notices to inform beneficiaries of their potential liability for a noncovered continued stay.
- The Preadmission/Admission HINN, used prior to an entirely noncovered stay, replaces HINNs 1 and 9.
To download the HINNs and instructions, please click on the appropriate link below.
