Aging Health Matters
This podcast will cover topics of interest to people who have Medicare. Episodes will include Medicare rights and health care. We hope you tune in for helpful tips that can improve the healthcare journey of you or someone you know.
Kepro is now Acentra Health.
All future podcast episodes will say "Acentra Health" - while older episodes (those posted prior to July 1, 2024) will refer to "Kepro." Rest assured, that all content about our free services for people who have Medicare are accurate. Our name has changed, but our services remain exactly the same.
Acentra Health is a Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO.
For more information about Acentra Health, please visit www.acentraqio.com.
Aging Health Matters
How the Appeals Medical Record Review Process Works
SUMMARY
As a contractor for Medicare, Kepro serves as the Beneficiary and Family Centered Care Quality Improvement Organization, also referred to as a BFCC-QIO. While Kepro provides BFCC-QIO services in 29 states, the general information is relevant to everyone who has Medicare (including Medicare Advantage) and everyone who works with people who have Medicare.
This episode talks about how the appeals medical record review process works. We have two guests today, who work at Kepro, Dr. Jessica Whitley, who is the Chief Medical Officer, and Rose Hartnett, the Director of Operations in the appeals department.
For more information about Kepro BFCC-QIO, please visit www.keproqio.com.
KEY TOPICS
01:58: Overview, introduction.
02:30: What is a medical record review and how the process works.
06:35: How you can be more engaged in your health care.
12:30: Things peer reviewers are looking for when they make determinations.
18:40: Getting your questions answered.
19:10: How Immediate Advocacy can help you, if your appeal is denied.
SUBSCRIBE
Subscribe to our newsletters: Case Review Connections, On the Healthcare Front
RESOURCES
- Read about appeals: https://keproqio.com/bene/appeal.aspx
- Watch a video about appeals: www.youtu.be/9q2TKqX0N6k
- Immediate Advocacy services: www.keproqio.com/ImmediateAdvocacy
- Information for stakeholders: www.keproqio.com/partners
- Information for people who have Medicare: www.keproqio.com/bene
Music: Motivational Upbeat Corporate by RinkevichMusic
https://soundcloud.com/rinkevichmusic
Video Link: https://youtu.be/U78mgVaM12M
