KEPRO - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
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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. Please pay close attention to the return fax number listed on the Medical Record Request documentation.

The Centers for Medicare & Medicaid Services instituted a new data entry system, which is not able to provide the necessary data for the online Case Status Update tool. Therefore, the online tool was discontinued on June 8, 2019.

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

KEPRO Service Areas
Click on a state below for a contact number and additional resources.
Telephone numbers have changed on June 8, 2019. Visit our transition page for details.

Region 1
Toll-free: 888-319-8452
Region 6
Toll-free: 888-315-0636
Region 10
Toll-free: 888-305-6759

Region 4
Toll-free: 888-317-0751
Region 8
Toll-free: 888-317-0891






quick links

Changes Effective June 8
Click Here for Info

MOA for Healthcare Providers

Update Your Provider Contact Info


 

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.



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