Hospital Discharge Medicare Checklist Tool
Answer a few plain-English questions and get a focused checklist of what to ask, what to keep, who to call, and what to verify before discharge, transfer, home setup, plan appeal, or payment.
Tell the tool what is happening
Choose the closest answer. The result is not a coverage decision; it is a structured call checklist.
Your focused checklist
Copy or print this before the next discharge, plan, facility, pharmacy, equipment, or billing call.
Key issue summary
- The first issue is that the next setting has not been named clearly enough.
- Coverage is unclear, so the first task is identifying every payer before accepting an answer.
- A denial or pending authorization should be handled from the written reason and deadline, not from a phone summary alone.
- First identify what document you have and what it is asking you to do.
Questions to ask before discharge or payment
- What is the exact next setting or service being recommended?
- Who has approved payment for it, and is that approval written down?
- What needs to happen before discharge, transfer, or payment?
- What is the deadline for appeal, follow-up, delivery, pickup, or payment?
- Can you write down the recommended next setting and why it is being recommended?
- What decision must be made today, and what can wait until a written notice or plan document is reviewed?
- What insurance, Medicare, Medicaid, or supplemental coverage is listed on the account?
- Which payer was contacted, and what did they say in writing?
- What exact service was denied or delayed?
Documents to request or keep
- Discharge instructions and medication list
- Written notices, denial letters, EOBs, MSNs, bills, or authorization decisions
- Names, dates, phone numbers, reference numbers, and deadlines from every call
- Provider orders for rehab, home health, equipment, supplies, medications, or follow-up care
- Written discharge plan, active problem list, current orders, and any plan or payer communication
- Denial notice, authorization request, clinical notes, appeal instructions, and reference numbers
- A labeled copy of each document with date received, sender, deadline, and action needed
Who to call
- Hospital case manager or discharge planner
- Hospital billing office or patient financial services, if there is a bill
- The insurance plan, Medicare Advantage plan, Medicaid office, or listed payer
- SHIP or another local counseling resource when Medicare decisions are unclear
- Hospital case manager, attending clinician, bedside nurse, and payer listed on the chart
- Hospital registration, billing office, plan member services, Medicare, Medicaid agency, and SHIP
- Plan utilization management department, ordering clinician, hospital case manager, and facility admissions office
Related guide, tools, and articles
Use the result above to organize the next call. Use these pages if one part of the issue needs more detail.
Use it before discharge
Ask the questions before the patient leaves, transfers, or loses access to the hospital team.
Use it during calls
Write down names, dates, reference numbers, deadlines, and the exact wording from each answer.
Verify with official sources
Use the tool to organize the question. Use official documents and professionals to verify the answer.
Want the printable version too?
The interactive checklist is the best starting point. The printable guide is still available as a slower, page-by-page reference.