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Medicare Forms: Second IMM May Be Trouble; HINN 11 'Is Underutilized'

When the attending physician is not on the same page as the rest of the medical team (case manager, physician advisor) about the medical necessity of continuing an inpatient admission, the hospital is required to give the patient the Hospital-Issued Notice of Noncoverage (HINN) 10, one of four HINNs in Medicare.

“This is when the patient is appropriate for discharge and has a safe discharge plan,” said Tiffany Ferguson, CEO of Phoenix Medical Management, at a May 28 Finally Friday webinar sponsored by the Appeal Academy.[1] The HINN 10 informs patients their attending physician doesn’t agree with the hospital’s determination that the patient no longer meets inpatient criteria, and that a neutral third party, the quality improvement organization (QIO), will decide who’s right. Ferguson cautions against using the HINN “as a weapon.” The HINN, like other Medicare forms, is simply designed to keep Medicare patients apprised of their rights and responsibilities.

The HINN 10 is the only HINN that can be used with Medicare Advantage and Original Medicare; HINNs 1, 11 and 12 are limited to Original Medicare, Ferguson said.[2]

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