The Quality Improvement Organization (QIO) Program is the cornerstone of Medicare’s efforts to improve the quality of care and health outcomes for beneficiaries. KEPRO is the Beneficiary and Family Centered Care QIO (BFCC-QIO) for 29 states. We offer information regarding beneficiary complaints, hospital discharge and skilled service termination appeals, and Immediate Advocacy.  On June 8, 2019, there were changes to the BFCC-QIOs that affected providers. To learn more about these changes, please visit our transition page.

KEPRO is currently experiencing a high call volume. We understand that there have been delays in reviews as well as wait times for phone calls. Due to technical challenges with government-furnished computer systems and for provider ease, KEPRO will temporarily use a different fax number. Effective immediately and until further notice, all medical records should be faxed to 844-878-7921.

KEPRO is glad to announce that the online Case Status Check tool is once again available. Medicare providers and patients can check the case status online for appeals cases started on or after July 14, 2019. 

Our staff is continuing to work hard to process all reviews and provide determinations, and we appreciate your patience during this transition period.

action items for healthcare providers

The Centers for Medicare & Medicaid Services (CMS) recently restructured the BFCC-QIO’s coverage area. If you are a provider in one of the areas shaded above in the map, you will need to take the following actions:

1. Update Your Appeals Notices
   Acute care providers will need to update the Important Message from Medicare, and post-acute providers will need to update the Notice of Medicare Non-coverage with KEPRO’s phone number for your region. Please note that it is acceptable to use labels to cover the existing BFCC information on the appeals notices.
   
   
2. Complete a Memorandum of Agreement (MOA) and Provider Update Form
   Visit www.keproqio.com/moa to complete the MOA and Provider Update Form. All providers are required to complete a new MOA, even if one was submitted in 2014.

For complete contact information and details, please visit our transition page. If your state is not listed above, Livanta is your BFCC-QIO effective June 8, 2019.

For information about the availability of auxiliary aids and services, please visit: http://www.medicare.gov/about-us/nondiscrimination/nondiscrimination-notice.html This website has been designed to comply with Section 508 of the U.S. Rehabilitation Act. If you have a disability and have trouble accessing information on any of these pages, please call the Helpline.