CaseWhy Hub · CaseWhy Appeals · Facilities · Skilled nursing

For skilled nursing facilities

A resident whose Medicare coverage is ending gets a Notice of Medicare Non-Coverage, and from that moment there is roughly a day to ask for a fast review. CaseWhy Appeals explains the notice to the family, writes the request, and tracks the clock — so the appeal happens inside the window instead of after it.

The clock, precisely

The NOMNC (CMS-10123) must be delivered at least two days before covered services end. The family must ask the Quality Improvement Organization for a fast review no later than noon of the day before services end. If they make that deadline, coverage generally continues while the QIO decides — and the QIO decides quickly.

That is the whole mechanism, and the reason it fails is almost never that the family didn't care. It's that the notice arrived on a Friday, the number on it goes to a recording, and nobody in the building had the time to sit down and explain what the form actually means.

Why this is your problem too

An appeal that succeeds keeps a resident in a covered bed while it is decided. An appeal that is never filed ends the stay on schedule. Your census, your discharge planning, and your relationship with the family all sit on the same side of that outcome as the family does.

Per-site licence

One licence covers the building — every nurse, social worker, and business-office staffer, one shared counter. A licensed site also gets the resource library: written guides, a video walkthrough, and audio explainers.

Your first 3 cases are free, whichever plan you're on. New skilled nursing facilities start on Volume — no plan to pick up front, and you can move to a monthly plan whenever your volume makes it cheaper.

If you run more than one building

Skilled nursing is far more consolidated than the facility count suggests: 14,690 Medicare-certified facilities resolve to roughly 5,184 independent decision-makers once common ownership is accounted for. If you're deciding for a group rather than a building, the per-site table above is the wrong shape — write to us and we'll price the group properly.