Appeals in Original Medicare

There are 5 levels of appeal. If you disagree with the decision made at any level of the process, you can usually go to the next level. At each level you'll get a decision letter with instructions on how to move to the next level.

Before you start an appeal, ask your provider or supplier for any information to make your appeal stronger.

Appeal when a hospital changes your status from "inpatient" to "outpatient with observation services"

As a result of a court order, you have appeal rights when a hospital changes your status from “inpatient” to “outpatient” if you also meet certain criteria.

You can ask for an appeal if you were admitted to the hospital as an inpatient on or after January 1, 2009, and your status was changed to “outpatient getting observation services” (and you meet certain other criteria). Learn how to file this type of appeal.

You can ask for a fast appeal while you’re still in the hospital if you were admitted to the hospital as an inpatient and the hospital changed your status to “outpatient getting observation services.” Learn how to file this type of appeal

Why does hospital status matter?

Your hospital status affects how much you pay for hospital services. Your hospital status may also affect whether Medicare will cover care you get in a skilled nursing facility (SNF) after your hospital stay.