Quality Improvement Organizations (QIOs) work under the direction of the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services. There are 53 QIOs responsible for each U.S. state, territory, and the District of Columbia.
To get the address and phone number of the QIO for your state or territory, visit www.ahqa.org on the web and click on “QIO Locator.” Or, you can call 1-800-MEDICARE (1-800- 633-4227) for help contacting your QIO. TTY users should call 1-877-486-2048.
Examples of Quality of Care Concerns
Medication errors
Example: Being given the wrong medication, or being given medication at the wrong time, or being given a medication to which you are allergic, or being given medications that interact in a negative way
Unnecessary or inappropriate surgery
Example: Being operated on for a condition that could effectively be treated with medications or physical therapy
Unnecessary or inappropriate treatment
Example: Being given the wrong treatment or treatment that you did not need, or being given treatment that is not recommended for patients with your specific medical condition.
Change in condition not treated
Example: Not receiving treatment after abnormal test results or when you developed a complication, such as an infection after surgery or a bedsore while in a skilled nursing facility
Discharged from the hospital too soon
Example: Being sent home while still having severe pain
Incomplete discharge instructions and/or arrangements
Example: Being sent home without instructions for the changes that were made in your daily medications while you were in the hospital, or during an office visit, you receive inadequate instructions about the follow-up care you need.
Help with other health care concerns
A concern about an issue other than the quality of care you received needs to be addressed by an agency other than a QIO. The agency that can help you depends on the nature of your concern. (Some concerns can be addressed by more than one agency.)
• If you have a concern about a doctor, such as unprofessional conduct, incompetent practice, or licensing questions, you may also contact your state medical board.
• If you have a concern about conditions at a hospital, such as rooms too hot or cold, cold food, or poor housekeeping, you may also contact your state department of health services.
• If you have a concern about Medicare fraud, call the HHS Office of Inspector General Hotline at 1-800-447-8477.
• If you have a concern about billing, such as questions about charges and what Medicare does or does not cover, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-4
(photo:http://www.flickr.com/photos/neilransom/108803427/)
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Randy Ryder is a Professor Emeritus at The University of Wisconsin-Milwaukee and is a publisher of Elder Parent Help.