Member Responsibilities when Appealing SNF, CORF or HHA Discharges
Medicare Advantage
Policy Number: MA-X-043
Last Updated: July 5, 2024
The chart below summarizes the effect on member responsibilities of appeal decisions related to discharges from Skilled Nursing Facility (SNF), Comprehensive Outpatient Rehabilitation Facility (CORF) or Home Health Aid (HHA) services.
| If... | Then... |
| The Quality Improvement Organization (QIO) agrees with the doctor’s decision to end covered services | The member is financially responsible for services on the date indicated on the Notice of Medicare Non Coverage. |
| The QIO disagrees with the doctor’s decision to end covered services | Blue Cross and Blue Shield of Nebraska will continue to cover the services. |
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