• The Important Message from Medicare is issued both at admission and two days prior to discharge. Remember that it is not issued if the patient is in observation.
• KEPRO's information and phone number have been updated on your facility's copy of the Important Message from Medicare.
• Weekend staff is familiar with the BFCC-QIO appeal process.
• The BFCC-QIO has the correct contact information for your facility, both for weekdays and weekends/holidays.

Immediate Advocacy - an informal process in which the BFCC-QIO acts as a liaison for the Medicare beneficiary to quickly resolve an oral complaint.

A Medicare beneficiary's daughter contacted the BFCC-QIO with concerns about her father. He was in the hospital and had a fever for the last three days. She had not been able to meet with the physician and was concerned that she had not received any information about the plan of care for her father. She was concerned that the medical staff was not taking her father's condition seriously.

The Intake Specialist was able to set up a conference call between the Patient Relations department and the daughter. The daughter was able to express her concerns regarding the lack of communication. The Patient Relations coordinator agreed to find out which hospitalist was assigned to her father and have him/her call the daughter.

The Intake Specialist received a call back from the Patient Relations coordinator. The daughter was able to speak with the hospitalist, share her concerns, and have her questions answered.

The BFCC-QIO is still responsible for the beneficiary complaint process. Beneficiaries and/or their representatives can file a complaint against a hospital related to the care that was received. The BFCC-QIO will do the quality of care review. If quality of care concerns are identified and a quality improvement activity (QIA) is needed, the Quality Innovation Network Quality Improvement Organization (QIN-QIO) will take over the QIA portion. Your facility will receive correspondence from your state QIN-QIO related to the QIA. The full original review process will still be completed by the BFCC-QIO.