How the Appeals Medical Record Review Process Works

Aging Health Matters

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.

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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