Attention Healthcare Providers: KEPRO is required to use the Centers for Medicare & Medicaid Services (CMS) designated case review system – QMARS – for appeals case reviews. From approximately 6 pm ET Monday (2/17) through 12:22 pm ET Tuesday (2/18), KEPRO did not receive medical record faxes for appeals cases. This disruption was associated with an outside vendor, and to date, KEPRO is not aware of the root cause.
If you sent a medical record during this time frame, please fax it again to the appropriate toll-free fax number listed on the medical record request. We will do our best not to make an administrative “disagree” decision due to missing documentation. Our appeals team will do its very best to try to mitigate any delays due to this disruption, which was outside of KEPRO’s control.
During this QMARS transition, two tools will be available below. Please choose the tool that matches the case ID format of your case. These QMARS cases will also have new fax numbers, so healthcare providers should pay close attention to the fax number listed on the medical record request.
We are aware that there have been delays, due to this transition, including long wait times. We are working diligently to resolve any issues and appreciate your patience and cooperation during this time.
CMS made changes to the Important Message from Medicare (IM) and Detailed Notice of Discharge (DND) forms and is requiring providers to begin using the new forms by April 1, 2020. Please visit our appeals page for more information.