Not long after Medicare was created, organizations were hired by the agency to provide consumer protections and other services to Medicare patients and their families. These organizations today are known as Quality Improvement Organizations (QIOs). Livanta is the Beneficiary and Family Centered Care QIO for Washington state. Of the many roles that Livanta plays for Medicare recipients and their families in Washington, two major programs are appeals and complaints.
As a Medicare beneficiary, you have the right to appeal a discharge decision after you’ve been admitted to a hospital or nursing home if you don’t feel ready to go home. You also have the right to appeal if home health services are ending before you feel ready. To appeal, all you have to do is call Livanta at 1-877-588-1123 before your scheduled discharge time (or end of services), and Livanta will immediately stop your discharge. You will remain in the facility (or continue to receive services) and you will continue to be covered under Medicare while Livanta is reviewing your appeal.
Livanta uses board certified physicians to review your medical record and decide if the facility’s decision is supported by that record. Then Livanta will notify you by phone and mail of its decision. This process should take between 24–72 hours. Even if the Livanta decision supports the discharge or end of services, if you are going home from a nursing home, you also have the right to 30 days of counseling support from a Livanta nurse or social worker to help ease your transition back to your home or next level of care.
In addition to discharge appeals, you have the right to complain if you feel you received poor quality care. If you are unsatisfied about any part of your care, call Livanta at 1-877-588-1123 to request a review.
If you are still in the facility when you call, Livanta may even be able to resolve ongoing issues the same day through a process called Immediate Advocacy. Through this process, you can request assistance to deal with issues ranging from difficulty scheduling appointments to receiving needed medical equipment, or any other issues you have with your doctor or other provider of care. If you have left the facility, you still have up to six months to use Immediate Advocacy, and up to three years to file a written complaint about your care. The formal written complaint process takes 30–60 days. A Livanta physician will review your medical record to determine if there was a medical mistake made during your care. If the Livanta team finds an issue, it will be referred to another agency that will work hard to ensure that the issue you experienced is never repeated.
Did you know?
There are two new ways to stay connected to your Medicare appeal or complaint cases. Livanta has created an online case tracking system called Arrow that allows you to track your case hour by hour with no complicated logins required and no confidential data showing.
Also, there’s a Livanta app for your smartphone. Go to the Google Play or Apple App Store and search for Livanta, download the app, explore your Medicare rights, and contact Livanta whenever needed with one easy touch of a button.
Livanta is an authorized U.S. government contractor to Medicare. Don’t hesitate to call Livanta at 1-877-588-1123 or use the app. For more information, visit www.livantaqio.com