Bring your complaints to your doctor and nurses as soon as possible. Be as specific as you can and ask how your complaint can be resolved. You can also ask to speak to a hospital social worker who can help solve problems and identify resources. Social workers also organize services and paperwork when patients leave the hospital.
Contact your state’s Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for complaints about the quality of care you got from a Medicare provider.
You can submit a complaint to your BFCC-QIO for things like getting the wrong medication, having the wrong surgery or treatment, or getting discharged too early. Learn more about filing a complaint on Medicare.gov.
You can also find your BFCC-QIO by calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-468-2048.
If you get an infection while you’re in the hospital or have problems getting the right medication, you can file a complaint with the Joint Commission . This group certifies many U.S. hospitals' safety and security practices and investigates complaints about patients' rights. It does not oversee medical care or how the hospital may bill you.
Visit Medicare.gov to find survey ratings from hospital patients about their care. You can compare information about a hospital’s performance against national averages for patient experiences, timely and effective care, complications, and more.
If you’re discharged before you're ready:
This is a big concern for many patients because sometimes insurers don’t approve long hospital stays. Talk to the hospital discharge planner (often a social worker) if you don't think you're medically ready to leave the hospital. The discharge planner will take your concerns to the doctor who makes this decision.
If you’re covered by Medicare or by a Medicare-managed care plan, you can file an appeal about a discharge while you’re still in the hospital. You should get a form from the hospital titled "An Important Message from Medicare," which explains how to appeal a hospital discharge decision. Appeals are free and generally resolved in two to three days. The hospital cannot discharge you until the appeal is completed. Learn more about Medicare appeals.
If you don’t agree with your hospital bill:
First, ask your doctor or the hospital's billing department to explain the charges. Then, find out how the hospital handles complaints about bills and make your case. Changes to federal law may help protect you from surprise medical bills and allow you to dispute your bill. If you have Medicare and you don’t agree with your bill, you can file an appeal.
You can also call 1-800-MEDICARE about billing questions. Make sure you have the date of service, the total charge in question, and the name of your doctor and hospital. TTY users can call 1-877-468-2048
Even with this information, it isn’t easy to be as assertive in a health care setting as it is in an auto repair shop or restaurant. But it's a smart move that can help you get the quality care that you deserve.