MPRO. Michigan's Quality Improvement Organization
APPEALS PROCESS
MPRO's nurse clinicians and physician reviewers handle all appeals.  MPRO processes appeals for care in the hospital setting, hospice, comprehensive outpatient rehabilitation facility, home health care, or skilled nursing facility.  When a Medicare patient is told that care is no longer covered by Medicare, beneficiaries and/or their representatives can appeal that decision to MPRO by calling:  1-800-365-5899.
 
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medicare consumers

CONTACT MPRO

24 hours a day/7 days a week - including holidays*

1-800-365-5899 (Toll-free number)

711 (TTY users)

 

*Note: Appeals calls received outside of normal business hours are taken by an answering service and returned by MPRO the next day.

MEDICARE APPEALS

As a Medicare beneficiary, you have the right to appeal health care decisions with which you disagree. There are two types of appeals:

Hospital Discharge Appeals

Request a Hospital Discharge Appeal from MPRO if you believe you are not medically ready to go home from the hospital, if you have a legitimate medical reason to continue receiving a medical service, or if you have not received clear discharge instructions.

 

Other Appeals

Request an appeal from MPRO if you disagree with the decision of your skilled nursing facility, comprehensive outpatient rehabilitation facility, home health agency, or hospice to discharge you.

 

 

 

 

 
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