Hospitals provide Hospital-Issued Notices of Noncoverage (HINNs) to beneficiaries prior to admission, at admission, or at any point during an inpatient stay if the hospital determines that the items or services the beneficiary is receiving, or is about to receive, are not covered because it is:
- Not medically necessary;
- Not delivered in the most appropriate setting; or
- Custodial in nature.
- HINN 10, also known as the Notice of Hospital Requested Review (HRR), should be issued by hospitals to beneficiaries whenever a hospital requests Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) review of a discharge decision without physician concurrence. HIINN 10 may be used for Original Medicare beneficiaries or Medicare Advantage enrollees.
- HINN 11 is used for noncovered items or services provided during an otherwise covered stay.
- HINN 12 should be used in association with the Hospital Discharge Appeal Notices to inform beneficiaries of their potential financial liability for a noncovered continued stay.
- The Preadmission/Admission HINN, used prior to an entirely noncovered stay, is also known as HINN 1.
The HINNs and instructions are in a zip file in the downloads section below.
Questions regarding HINNs can be submitted at: https://appeals.lmi.org