- Frequently Asked Questions about the “Observation Status” Court Decision
- Recorded Webinar (Jan. 22, 2025) on Observation Status Appeals
- Retrospective Appeals Flowchart
- Prospective Appeals Flowchart
- Request for Retrospective Appeal of Medicare Part A Coverage – to request a retrospective appeal.
- Check status of a submitted Retrospective Appeal that has an “EC” number (found on correspondence from Eligibility Contractor)at q2a.com/Patient-Status-Appeal-Rights
- Medicare Change of Status Notice – to be issued by hospitals to patients eligible to submit prospective appeals.
- Case Study – Observation Status Appeal Results in Nursing Home Coverage
- Observation Status Appeal Results in Hospital Coverage
- Instructions from the Centers for Medicare & Medicaid Services (CMS) on Patient Status Appeals.
- Appointment of Representative form – to appoint someone to act on your behalf for a Medicare appeal.
- CMS booklet on Medicare Appeals.
- NAELA News Article on Observation Status Appeals
- State Health Insurance Assistance Program (SHIP) – free, personalized Medicare counseling and help filing complaints. Find your local SHIP on the website. Some programs assist with appeals.
- LawHelp.org – free legal aid and other low-cost legal help. Some programs assist with Medicare appeals. Eligibility requirements may apply.
- Information on requesting medical records: https://triagecancer.org/statelaws/medical-records
- 1-800-MEDICARE – call to request Medicare forms, or to ask for information about appeals.
- CMS Guidance to Providers on Claim Submission Following Favorable/Partially Favorable Retrospective Status Change Appeals: MLN Fact Sheet (Jan. 2025)
- Change of Status Notice Instructions From CMS for Providers: MLN Matters No. MM13846 (Nov. 2024)
- CMS Billing Instructions for Providers For Expedited Change of Status Appeals: MLN Matters MM13938 (Oct. 2024)