When a hospital determines that a fee for service Medicare beneficiary no longer needs inpatient care, but is unable to obtain the agreement of the physician, the hospital may request a QIO review. The Notice of Hospital Requested Review (HRR) should be issued by the hospital to the beneficiary whenever a hospital requests QIO review of a discharge decision without physician concurrence. Please click here to view the HRR. Please notify TMF at 1-800-725-9216 when you issue a HRR and send the HRR and the medical record to:
TMF Health Quality Institute
Review and Compliance
Bridgepoint I, Suite 300
5918 West Courtyard Drive
Austin, TX 78730-5036
TMF will make a determination and notify the beneficiary, the hospital, and the physician of its decision within two business days of the hospital’s request and receipt of any pertinent information submitted by the hospital.
For TMF appeal contact information click here.